+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Introduction of long-term care insurance: changes in service usage

Introduction of long-term care insurance: changes in service usage

Japanese Journal of Public Health 60(9): 586-595

With the aging of the population, Japan's long-term care system has shifted from a welfare-placement system to a social-insurance system, which is a precedent of policies for the elderly. We examined how individuals who used care services before the implementation of long-term care insurance (LTCI) (previous service users) currently use the LTCI services, with a focus on the processes of service use. Panel data were obtained from the Nihon University Japanese Longitudinal Study of Aging database. These data were collected by interviews conducted before (November 1999 and March 2000) and after (November 2001 and December 2001) the establishment of LTCI. Among the 3992 individuals who participated in these interviews, 416 of the previous service users, aged ≥65 years, were sampled. The outcome measures were the processes of using LTCI services (application for LTCI, certification of long-term care need, and contract with LTCI service providers). Logistic regression analysis was performed to identify individual factors associated with the process of application for LTCI. There were 133 LTCI users among the 416 previous service users (32.0%). Of the service processes used, 45.5% of previous service users were applicants, 85.7% of the applicants were certified individuals, and 88.7% of those certified used services with service contracts. The application process was significantly easier for individuals with disease (odds ratio[OR], 8.34 : 95% confidence interval [CI], 1.86-37.46), those dependent for their instrumental activities of daily living (IADL) (OR, 11.21 : 95% CI, 5.22-24.07), those with an equivalent income of <1.25 million yen (OR, 2.72 : 95% CI, 1.30-5.69), and those who had used respite care (OR, 3.29 : 95% CI, 1.16-9.35) previously. In contrast, the application process was significantly difficult for community rehabilitation users (OR, 0.38 : 95% CI, 0.17-0.82). Only half of the previous service users were applicants, and they had severe diseases or were more dependent for their IADL. Our findings suggest that many individuals who were functionally independent were covered under the welfare-placement system. Additionally, low-income individuals did not refrain from applying.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 053956869

Download citation: RISBibTeXText

PMID: 24125818

Related references

Changes of care status before and after the introduction of the long-term care insurance in Japan--results of care status before the long-term care insurance. Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 39(1): 20-21, 2002

Activities in daily life and changes in care level among users of Preventive Care Service under Long-Term Care Insurance. Nihon Eiseigaku Zasshi. Japanese Journal of Hygiene 67(3): 401-407, 2012

Problems impeding the introduction of care services under the long-term care insurance system. Japanese Journal of Public Health 59(3): 139-150, 2012

Introduction of insurance system for long-term care. Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 34(12): 970-972, 1998

Public health nurses' activities after the initiation of long-term care insurance (Part 1). Focus on operations for long-term care insurance. Japanese Journal of Public Health 50(8): 713-723, 2003

Sex Differences in Service Usage in Long-Term Psychiatric Care. British Journal of Psychiatry 158(S10): 75-79, 1991

Burden on family caregivers of frail elderly persons one year after the introduction of public long-term care insurance service in the Onga District, Fukuoka Prefecture: evaluation with a Japanese version of the Zarit caregiver burden interview. Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 40(2): 147-155, 2003

Aged care service delivery in Japan: preparing for the long-term care insurance scheme. Journal of Aging and Social Policy 13(2-3): 21-34, 2002

Warfarin usage in octogenarians: report from a long-term care anticoagulation service with point of care INR testing & community pharmacists. Journal of Thrombosis and Thrombolysis 25(1): 122-122, 2008

Long-term care insurance and market for aged care in Japan: focusing on the status of care service providers by locality and organisational nature based on survey results. Australasian Journal on Ageing 33(3): 153-157, 2015

The prevalence and characteristics of long term care insurance clients who are judged to need frequent home visiting service by their care managers. Japanese Journal of Public Health 60(6): 370-376, 2014

A new social insurance system covering long-term care service. Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 34(12): 973-976, 1998

Change in the income status of the disabled after introduction of long-term care insurance. Zeitschrift für Gerontologie 25(3): 178-185, 1992

Sex differences in service usage in long-term psychiatric care are women adequately served?. British Journal of Psychiatry. Suppl. 1991(10): 75-79, 1991

The evaluation of the public long-term care insurance: from the perspective of the service users. Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 41(3): 278-280, 2004