The Japanese public long-term care insurance for the elderly is unequivocally a problem both for the health care system and as a social issue. The issues for the socially hospitalized and institutionalized are still unsolved due to a lack of family and community support. A central feature is to investigate the behavioral choices among elderly formal/informal home care and nursing home care. This study uses the General Survey on Actual Living Conditions of Elderly People as a natural experiment to analyze behavioral decision-making between the nursing home care and community-based formal/informal home care among the elderly. A logit model analysis that controls for socio-economic, demographic and physical/mental health influential factors was conducted. Developing community-based formal/informal home care would lead to economic gains. A provision of compensation to family health caregivers for their informal home care for the elderly is a key factor and a viable option. The Geneva Papers (2006) 31, 600–632. doi:10.1057/palgrave.gpp.2510101

Using a microsimulation model named Integrated Analytical Model for Household Simulation (INAHSIM), the author conducted a household projection in Japan for the period of 2010—2050. INAHSIM-II specifically means that the initial population is created using the INAHSIM model itself. The model produces outputs such as (a) the number of the elderly according to dependency and/or living situations, (b) the relative parents/children ratio taking into account the number of brothers and sisters, and (c) a 1-year transition matrix by household type. As an application of the model, a projection of health and long-term care expenditures is made for the years 2010—2050 in Japan.

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By using a dynamic micro-simulation model named INAHSIM-II, we conducted a population-household projection in Japan (INAHSIM 2017) for the period of 2015-2065. Due to rapid aging of the population, the distribution of the elderly (65 years old or older) by dependency level has a profound impact on health expenditure (namely medical expenditure and long-term care expenditure) of the elderly. In this paper, we estimated health expenditure of the elderly in 2025-2065, using the results of the projection of the elderly by dependency level.

We defined the depenadency level of the elderly, and calculated the annual transition probability of dependency level in Japan. Then incorporating this transition probability into a dynamic micro-simulation model named INAHSIM-II, we calculated expected years of each dependency level from birth for future years, applying the life table method. In this way, expectation of independent living at birth was obtained from the simulation, and we conclude that although extension of Healthy Life Expectancy is desirable, extension of Expectation of Independent Living is more important as a public health objective.Correspondence to: Tetsuo Fukawa, Co-representative, Institution for Future

By using a microsimulation model named INAHSIM, we conducted a household projection in Japan for the period of 2011–2060. Due to rapid aging of the population, the distribution of the elderly (65 years old or older) by living arrangement and dependency level has a profound impact on the future social burden. In this paper, we measured the social burden of the elderly by three variables: (1) institutionalization rate (percentage of the elderly living in institutions), (2) parent-child ratio (relative number of old parents taking into account the number of brothers and sisters), and (3) one-year transition matrix of the elderly by household type. Especially, the choice of the elderly among (a) living independently, (b) coresident with child households, and (c) moving to institutions are crucial indicators for the future social burden of the elderly in Japan.

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By using a dynamic micro-simulation model named INAHSIM, we conducted a population-household projection in Japan for the period of 2015 to 2070. Due to rapid aging of the population, the distribution of the elderly (65 years old or older) by living arrangements has a profound impact on the social system. Especially, the choice of the elderly among a) living in one-person households, b) co-residing with child households, and c) living in institutions, are crucial indicators for the future social burden of the elderly in Japan. In this paper, we projected the number and proportion of the elderly by living arrangement in future years. Trends of those elderly who have little relatives, therefore having high risk of dying in solitude, were also featured.Keywords: dynamic micro-simulation, population-household projection, living arrangements of the elderly, co-residing with a child, institution rate, solitary rate INAHSIM is a dynamic micro-simulation model, which was first developed in 1984-85 in Japan (Note 1). From the INAHSIM model, we can obtain a population-household projection in a coherent manner as well as dynamic statistics which are difficult to obtain from static surveys or macro simulation (Fukawa, 2012). As an example of such output, we prepared an index named solitary rate of the elderly.In this paper, basic features of the INAHSIM 2018 Simulation were described in Section 2, and results about living