The long term care insurance law in Japan: Impact on institutional care facilities

Naoki Ikegami, Keita Yamauchi, Yukari Yamada

研究成果: Review article査読

52 被引用数 (Scopus)


Background: Following the introduction of the public long-term care (LTC) insurance in Japan on 1 April 2000, funding that had been split between the health and social welfare sectors was unified. All elderly people 65 and over have become entitled to receive benefits according to their eligibility level, regardless of income or family support. Except for those assessed as in the least dependent group, individuals can choose either community care or institutional care, with only the cost of food an additional payment for the latter. Method: Review of the development and implications of long term care insurance provision for older people and analysis of quality based on resident level data. Results: Despite the structural changes, the impact of the new programme has had minimal impact upon the providers of institutional care. The three types of facilities that had provided LTC have continued to function independently, basically retaining the same staffing requirements and charges. For indicators adjusted for risk, the quality of care tended to be higher in designated LTC hospital beds. Conclusions: Appropriate balance between institutional and community care and triaging among the three different types of facilities remains difficult because decisions rest with the individual. Indicators of quality must take into account differences in case-mix among the facility types. However, there are few incentives for providers to improve quality because demand is likely to be increasingly greater than supply. Whether the generous provisions of the new programme will prove to be sustainable remains to be seen.

ジャーナルInternational Journal of Geriatric Psychiatry
出版ステータスPublished - 2003 3月 1

ASJC Scopus subject areas

  • 老年医学
  • 精神医学および精神衛生


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