Title: Estimating Expenditure on LongTerm Care LTC in Japan
1Estimating Expenditure on Long-Term Care (LTC)
in Japan
- SAKAMAKI, Hiroyuki, MBA
- Institute for Health Economics and policy (IHEP)
- Tokyo,Japan
10th Oct, 2002, OECD Paris
2Presentation Outlines
- Estimates on Expenditure for LTC
- Estimation Processes and Issues until 1999
- Public Long Term Care Insurance (LTCI) in 2000
- Estimation Strategy after 2000
3Graying population in Japan
- Population (?65yo)
- 4.16 M ( 4.9) in 1950
- 21.19M (16.7) in 1999
- 33.12M (27.4) in 2025
4Expenditures including for long-term care in
Japan until 1999
Expenditure on long-term in-patient nursing care
(HC.3.1)
-Expenditure for health service facilities for
the elderly (HP.2.1) -Estimated
expenditure for meal service for inpatients in
hospitals for the elderly (HP.1.1) -Estimated
expenditure for inpatient care in hospitals for
the elderly (HP.1.1) Expenditure on long-term
home health care (HC.3.3) -Expenditure for
home-visit nursing care for the elderly
(HP.1.1)
5Facility services providing LTC
- Long term care welfare facilities for the aged
LTCW special nursing home for the aged - Long term care health facilities for the aged
LTCH facilities of health care services for
the aged - Long term care medical treatment facilities
LTCM medical treatment beds, beds for
treatment of senile dementia, LTC strength
building hospital.
6Expenditure for long-term care in Japan for 1999
7Financing of long-term care in Japan for 1999
(Million Yen)
8Expenditures for long-term care by function of
care and provider industry in Japan of 1999 (SHA
table 2)
(Million Yen)
9Estimation process (1)
- Total expenditure on long-term nursing care
(HC.3.1) - sum of following 3 items
- ?Expenditure for health service facilities for
the elderly(HP.2.1) - National health expenditure for health
facilities for the elderly (Public) - Fee for health facilities for the elderly
(private) - ?Estimated expenditure for meal service for
inpatients in hospitals for the elderly (HP.1.1) - National health expenditure for meal services
during hospitalisation related to hospitals - Proportion of the number of working beds for
the elderly to the total number of working beds - ?Estimated expenditure for inpatient care in
hospitals for the elderly (HP.1.1) - National health expenditure for inpatient care
in hospitals for the elderly - Estimated proportion of amount of inpatient
care in hospitals for the elderly, on the basis
of official statistics
10Estimation process (2)
- Total expenditure on long-term home health care
(HC.3.3) - Expenditure for home-visit nursing care for the
elderly (HP.1.1) - Private expenditure on long-term home health care
- total expenditure on long-term health care
- patients payment about home-visit nursing care
for the elderly. - Public expenditure on long-term home health care
- total expenditure on long-term health care
- -private expenditure on long-term health care
11Issues of estimation
- ?Date source necessary for estimates of
expenditure items that conceptually exist are not
available. This may cause underestimate.For
example, expenditure for day cases of long-term
nursing care (HC.3.2) - ? Boundary of LTCPersons who need long-term care
(NOT health services) were covered by the Medical
Insurance due to insufficiency of the Long-term
Insurance system before 2000. - ?Introducing Long Term Care Insurance System
(LTCI) in 2000Consistency should be needed
before/after introducing LTCI.
12Trend of National Medical Expenditure
13Before and after enforcement of LTCI
After
Before
Official statistics about LTCI
No available data
Total expenditure for long-term care, defined by
SHA
Data sources
National medical expenditure
National medical expenditure
14Public Long Term Care Insurance System (LTCI)
- ? Established in April 2000.
- ? Insurer the municipalities
- ? Insured people aged 40 and above
- ? Eligible
- - People aged 65 or older in need of care or
support - - People aged from 40 to 64 who are participants
of medical insurance, in need of care or support
due to a disease caused by aging such
aspresenile dementia or cerebrovascular
disorders, etc
15Integration of Health and Welfare
Welfare for the Aged
Medical services for the Aged
Under Health Insurance Long LoS Not equiped for
LTC
From gov. budget The municipalities driven Means
tested
April 2000
Long term care insurance
Social insurance
16Financing of LTCI
Public Expenditure (HF.1.1)
? 2001 budget 4,770 billion yen co-pays 560
billion yen Provision 4,210 billion yen
Apart from co-payment of the users.
The users pay 10 of the benefit amount.
17Estimating Strategy for LTCI
- Discrimination b/w LTC and Healthcare services
- by Providers
- by Function of Services
- by Degree of Need of LTC
18Facility services
19Benefits of LTCI
Persons requiring long term care or support will
receive benefits in the following services. -
In-home services - Facility services
20In-home services
21Degree of Need of LTC
22SHA application of LTC
Include in HHA
23Conclusion
- Pilot Study to estimate LTC will start beginning
of 2003, when all relevant data will be published.
24Japan SHA Team
- Koki HAYAMIZU
- Tastuo IHARA
- Yoshiyuki OZAWA
- Hiroyuki SAKAMAKI
- Manabu YAMAZAKI