Long-Term Care System in Japan

Abstract

Origin of Welfare in Japan Hidenin (悲田院 in Japanese) appears to be the first precursor of today's welfare institutions for older people in Japan. Hidenin is a Buddhist temple built in the 6th century in Kyoto that aimed to care for the poor and children, as well as older people, who could not look after themselves and who could not be cared for by their community or family. It is one of the oldest welfare facilities for older people in the world. As in other Asian countries, Buddhism was an influential factor behind early welfare activities in Japan. Before the Introduction of the LTCI System The proportion of older people aged 65 years or over in Japan was less than 5% in 1950. After the first and second baby booms following World War II, Japan has experienced unprecedented aging of its population. Owing to the low birth rate and an increasing trend in the number of nuclear families in addition to population aging, in the late 20th century, many older people were admitted to and remained in hospitals because their families were unable or unwilling to look after them. The associated increase in medical expenditure for this so-called "social admission" became a serious issue for society. Although the Japanese government implemented a 10-year strategy for the health and welfare of older people (the "Gold Plan") in 1989, the system encountered financial issues owing to its reliance on tax revenue and its increasing expenditure. This is a major reason for the implementation of the long-term care insurance (LTCI) system.

Characteristics of Departments That Provided Primary Support for Households with Complex Care Needs in the Community: A Preliminary Cross-Sectional Study

“…Owing to the super-aged society, health services for older people have developed rapidly in Japan [ 11 ]. The long-term care insurance system focused on reducing family caregiving and sharing long-term care costs by providing integrated medical and welfare care since 2000 [ 20 ]. Despite the national universal health insurance coverage system instituted in 1961, preventive care systems based on self-care and mutual aid along with the welfare system still assume family caregiving is provided in households in Japan [ 21 ].…”

Frailty is associated with susceptibility and severity of pneumonia in older adults (A JAGES multilevel cross-sectional study)

“…“The LTCI system was introduced in Japan in 2000 to address the demands of older persons with disabilities based on the concept of a user-oriented social insurance system with support for independence. Older people with a certification for LTCI service needs can utilize facility services, in-home services, and community-based services depending on their physical and cognitive impairments” 12 .…”

The International Classification of Functioning, Disabilities, and Health Categories Necessary for Care Planning for Older Patients with Heart Failure: A Survey of Care Managers in Japan

“…In Japan, under the long-term care insurance system, care managers prepare a home care plan [8][9][10].…”