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• W2000732933 abstract "Yumiko Arai (May 26, p 1713)1Arai Y Japan's new long-term care insurance.Lancet. 2001; 357: 1713Summary Full Text Full Text PDF PubMed Scopus (25) Google Scholar insists that Japan's new long-term care insurance serves elderly people well.1Arai Y Japan's new long-term care insurance.Lancet. 2001; 357: 1713Summary Full Text Full Text PDF PubMed Scopus (25) Google Scholar In July, the Ministry of Health and Welfare of Japan reported that medical costs for 2000 were 2·1% less than those for 1999. Thus, the new insurance has lowered the medical cost for elderly people.2Willis DA Long-term care: a substantive factor in financial planning.J Indiana Dent Assoc. 2000; 79: 22-23PubMed Google ScholarHowever, the families of disabled elderly and handicapped people still struggle against chronic diseases. A survey from Sendai, north Japan, showed that 25% of elderly people and their families who used the long-term care insurance service do not understand or are not concerned with it. Only 32% of the consumers were satisfied with the insurance. Most of the frail elderly people and their families felt that the cost of the service is high and the coverage is difficult to understand. Thus, the benefits and duties of long-term care in elderly and younger people need to be clarified.Many private or institutional short- term care facilities have been built in Japan in response to the new insurance. However, to balance out these costs, patients who have grade 3·5 disability (0 is lowest, 5 is highest) need to be treated. The grade of disability does not always reflect the patients' disorders or the caregivers' difficulties.3Shimada C Iwashita K Care networks of visiting nurse agencies before the long-term care insurance act.Nippon Koshu Eisei Zasshi. 2001; 48: 304-313PubMed Google Scholar, 4Masuda Y Kuzuya M Uemura K et al.The effect of public long-term care insurance plan on care management and care planning in Japanese geriatric hospitals.Arch Gerontol Geriatr. 2001; 32: 167-177Crossref PubMed Scopus (2) Google Scholar For example, handicapped patients without dementia, who cannot move by themselves can be classified as grade 4–5. More energetic and physically healthy elderly patients with dementia under supervision of caregivers are graded as 2–3. Surprisingly, in some instances, bedridden patients who cannot change position by themselves can be graded as 3. The short-term-care facilities are likely to select the grade 4–5 patients. Furthermore, because of economic reasons, short-term-care facilities sometimes accept these healthier patients for longer than 3 months.The original concept of long-term care insurance in Japan was to support home care, but the short-term care facilities may weaken this Japanese tradition. Some families in urban areas are enthusiastic about the service. Satisfaction with the service is low in central Tokyo, where the Japanese tradition is very weak. A descriptive analysis of existing policies and consumer practices raises the question of whether recent incremental reforms will lead to future solutions for the major constituents most affected by their implementation.5Rivers PA McCleary KJ Glover SH Long- term care financing: are current methods enough?.J Health Hum Serv Adm. 2000; 22: 472-494PubMed Google Scholar The revised long-term care insurance system is urgently needed to support frail individuals and their families. Yumiko Arai (May 26, p 1713)1Arai Y Japan's new long-term care insurance.Lancet. 2001; 357: 1713Summary Full Text Full Text PDF PubMed Scopus (25) Google Scholar insists that Japan's new long-term care insurance serves elderly people well.1Arai Y Japan's new long-term care insurance.Lancet. 2001; 357: 1713Summary Full Text Full Text PDF PubMed Scopus (25) Google Scholar In July, the Ministry of Health and Welfare of Japan reported that medical costs for 2000 were 2·1% less than those for 1999. Thus, the new insurance has lowered the medical cost for elderly people.2Willis DA Long-term care: a substantive factor in financial planning.J Indiana Dent Assoc. 2000; 79: 22-23PubMed Google Scholar However, the families of disabled elderly and handicapped people still struggle against chronic diseases. A survey from Sendai, north Japan, showed that 25% of elderly people and their families who used the long-term care insurance service do not understand or are not concerned with it. Only 32% of the consumers were satisfied with the insurance. Most of the frail elderly people and their families felt that the cost of the service is high and the coverage is difficult to understand. Thus, the benefits and duties of long-term care in elderly and younger people need to be clarified. Many private or institutional short- term care facilities have been built in Japan in response to the new insurance. However, to balance out these costs, patients who have grade 3·5 disability (0 is lowest, 5 is highest) need to be treated. The grade of disability does not always reflect the patients' disorders or the caregivers' difficulties.3Shimada C Iwashita K Care networks of visiting nurse agencies before the long-term care insurance act.Nippon Koshu Eisei Zasshi. 2001; 48: 304-313PubMed Google Scholar, 4Masuda Y Kuzuya M Uemura K et al.The effect of public long-term care insurance plan on care management and care planning in Japanese geriatric hospitals.Arch Gerontol Geriatr. 2001; 32: 167-177Crossref PubMed Scopus (2) Google Scholar For example, handicapped patients without dementia, who cannot move by themselves can be classified as grade 4–5. More energetic and physically healthy elderly patients with dementia under supervision of caregivers are graded as 2–3. Surprisingly, in some instances, bedridden patients who cannot change position by themselves can be graded as 3. The short-term-care facilities are likely to select the grade 4–5 patients. Furthermore, because of economic reasons, short-term-care facilities sometimes accept these healthier patients for longer than 3 months. The original concept of long-term care insurance in Japan was to support home care, but the short-term care facilities may weaken this Japanese tradition. Some families in urban areas are enthusiastic about the service. Satisfaction with the service is low in central Tokyo, where the Japanese tradition is very weak. A descriptive analysis of existing policies and consumer practices raises the question of whether recent incremental reforms will lead to future solutions for the major constituents most affected by their implementation.5Rivers PA McCleary KJ Glover SH Long- term care financing: are current methods enough?.J Health Hum Serv Adm. 2000; 22: 472-494PubMed Google Scholar The revised long-term care insurance system is urgently needed to support frail individuals and their families." @default.
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• W2000732933 title "Pitfalls of new long-term care insurance in Japan" @default.
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