Population ageing and wellbeing: lessons from Japan's long-term care insurance policy

Japan's population is ageing rapidly because of long life expectancy and a low birth rate, while traditional supports for elderly people are eroding. In response, the Japanese Government initiated mandatory public long-term care insurance (LTCI) in 2000, to help older people to lead more indepe...

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Published inThe Lancet (British edition) Vol. 378; no. 9797; pp. 1183 - 1192
Main Authors Tamiya, Nanako, Prof, Noguchi, Haruko, PhD, Nishi, Akihiro, MD, Reich, Michael R, Prof, Ikegami, Naoki, Prof, Hashimoto, Hideki, Prof, Shibuya, Kenji, Prof, Kawachi, Ichiro, Prof, Campbell, John Creighton, Prof
Format Journal Article
LanguageEnglish
Published Kidlington Elsevier Ltd 2011
Elsevier
Subjects
Biological and medical sciences
birth rate
elderly
family support
Female
General aspects
Health Status
household income
households
Humans
Internal Medicine
issues and policy
Life Expectancy
long term care
long term care insurance
longevity
Male
Medical sciences
Miscellaneous
national surveys
people
Preventive Health Services
Public health. Hygiene
Public health. Hygiene-occupational medicine
Japan
Asia
Human
Medicine
Health policy
Insurance
Ageing
Well being
Population
Public health
Long term care
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Summary:Japan's population is ageing rapidly because of long life expectancy and a low birth rate, while traditional supports for elderly people are eroding. In response, the Japanese Government initiated mandatory public long-term care insurance (LTCI) in 2000, to help older people to lead more independent lives and to relieve the burdens of family carers. LTCI operates on social insurance principles, with benefits provided irrespective of income or family situation; it is unusually generous in terms of both coverage and benefits. Only services are provided, not cash allowances, and recipients can choose their services and providers. Analysis of national survey data before and after the programme started shows increased use of formal care at lower cost to households, with mixed results for the wellbeing of carers. Challenges to the success of the system include dissatisfaction with home-based care, provision of necessary support for family carers, and fiscal sustainability. Japan's strategy for long-term care could offer lessons for other nations.
Bibliography:http://dx.doi.org/10.1016/S0140-6736(11)61176-8
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ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(11)61176-8