Changing social burden of Japan’s three major diseases including Long-term Care due to aging (original) (raw)
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PLOS ONE
Background Three major diseases in Japan, cancer, heart disease, and cerebrovascular disease (CVD) are the leading causes of death in Japan. This study aimed to clarify the social burden of these diseases, including long-term care (LTC), and to predict future trends. Methods The comprehensive cost of illness (C-COI), a modification of the cost of illness (COI), was used to estimate the social burden of the three major diseases in Japan. The C-COI can macroscopically estimate both direct and indirect costs, including the LTC. A new method for future projections of the C-COI was developed according to the method for future projections of the COI. All data sources were government statistics. Results The C-COI of cancer, heart diseases, and CVD in 2017 amounted to 11.0 trillion JPY, 5.3 trillion JPY, and 6.5 trillion JPY, respectively. The projected future C-COI in 2029 was 10.3 trillion JPY, 5.3 trillion JPY, and 4.4 trillion JPY, respectively. In 2029, the LTC costs accounted for 4.4%...
Asia-Pacific Journal of Health Management, 2019
Background: Aging in Japan is advancing most rapidly in the world, and is expected to increase demand of medical services more in near future. Aging is uneven and progress of the aging varies from regions resulting in great differences in medical needs. In order to supply the needs for medical services, Japanese government developed “Regional Medical Vision”, which estimates the near future requirements for medical resources. However, this is a plan for redistribution of medical resources taking into only future changes of population composition based on current situation. In fact, each region has diversity of medical needs, and it is difficult to use average medical needs even if they are adjusted by population structures. In consideration of such situation, we tried to estimate the social burden of major diseases of each region in order to estimate the medical needs. We picked up cerebrovascular diseases (CVD, ICD10 code: I60 - I69) and dementia (ICD10code: F01, F03, G30), and cal...
Archives of Gerontology and Geriatrics, 2014
We surveyed the care burden of family caregivers, their satisfaction with the services, and whether their care burden was reduced by the introduction of the LTCI care services. We randomly enrolled 3000 of 43,250 residents of Nagoya City aged 65 and over who had been certified as requiring long-term care and who used at least one type of service provided by the public LTCI; 1835 (61.2%) subjects returned the survey. A total of 1015 subjects for whom complete sets of data were available were employed for statistical analysis. Analysis of variance for the continuous variables and x 2 analysis for that categorical variance were performed. Multiple logistic analysis was performed with the factors with p values of <0.2 in the x 2 analysis of burden reduction. A total of 68.8% of the caregivers indicated that the care burden was reduced by the introduction of the LTCI care services, and 86.8% of the caregivers were satisfied with the LTCI care services. A lower age of caregivers, a more advanced need classification level, and more satisfaction with the services were independently associated with a reduction of the care burden. In Japanese LTCI, the overall satisfaction of the caregivers appears to be relatively high and is associated with the reduction of the care burden.
International Journal for Quality in Health Care, 2018
Objective: To analyze the chronological change in social burden of dementia in Japan for policy implications of appropriate resource allocation and quality improvement. Design: National, population-based, observational study from 2002 to 2014. Setting: Seven nationwide data sets from Japanese official statistics. Method: Comprehensive Cost of Illness method. Main outcome measures: The outcome variables included healthcare services, nursing care services, informal care (unpaid care offered by family and relatives), mortality cost and morbidity cost. Results: The number of patients with dementia increased 2.50 times from 0.42 million in 2002 to 1.05 million in 2014. While the number of patients living in homes and communities increased by 3.22 times that of patients living in nursing care facilities increased by 1.42 times. The total social burden increased 2.06-2.27 times from JPY 1.84-2.42 to 3.79-5.51 trillion (JPY 1 trillion = US$ 100 billion). Regarding the total burden, the proportion of informal care provided increased from 36.6-51.9% to 37.7-57.2%. Furthermore, the proportion of primary caretakers aged ≥70 years increased from 27.6% to 37.6%. Conclusions: Owing to the promotion of 'Deinstitutionalization' (shift of nursing care site from infacilities to in-home and in-community), 'Elderly care by the elderly,' and 'Earlier diagnosis of dementia,' the average cost per patient reduced by 0.82-0.91 times from JPY 4.37-5.77 to 3.60-5.24 million. Therefore, the management of informal care in a manner that does not exceed the acceptable limit of the patients' caretakers, while maintaining patient safety and quality of care, is imperative.
Micro data analysis of medical and long-term care utilization among the elderly in Japan
International journal of environmental research and public health, 2010
Japan is currently experiencing the most rapid population aging among all OECD countries. Increasing expenditures on medical care in Japan have been attributed to the aging of the population. Authors in the recent debate on end-of-life care and long-term care (LTC) cost in the United States and Europe have attributed time to death and non-medical care cost for the aged as a source of rising expenditures. In this study, we analyzed a large sample of local public insurance claim data to investigate medical and LTC expenditures in Japan. We examined the impact of aging, time to death, survivorship, and use of LTC on medical care expenditure for people aged 65 and above. On the basis of these findings, we conclude that age is a contributing factor to the rising expenditures on LTC, and that the contribution of aging to rising medical care expenditures should be distinguished according to survivorship.
Cost of illness of ischemic heart disease in Japan: a time trend and future projections
Environmental Health and Preventive Medicine
Background: Ischemic heart disease (IHD/ICD10: I20-I25) is the second leading cause of deaths in Japan and accounts for 40% of deaths due to heart diseases. This study aimed to calculate the economic burden of IHD using the cost of illness (COI) method and to identify key factors that drive the change of the economic burden of IHD. Methods: We calculated the cost of illness (COI) every 3 years from 1996 to 2014 using governmental statistics. We then predicted the COI for every 3 years starting from 2017 up to 2029 using the fixed and variable model estimations. Only the estimated future population was used as a variable in the fixed model estimation. By contrast, variable model estimation considered the time trend of health-related indicators over the past 18 years. We derived the COI from the sum of direct and indirect costs (morbidity and mortality). Results: The past estimation of COI slightly increased from 1493.8 billion yen in 1996 to 1708.3 billion yen in 2014. Future forecasts indicated that it would decrease from 1619.0 billion yen in 2017 to 1220.5 billion yen in 2029. Conclusion: The past estimation showed that the COI of IHD increased; in the mixed model, the COI was predicted to decrease with the continuing trend of health-related indicators. The COI of IHD in the future projection showed that, although the average age of death increased by social aging, the influence of the number of deaths and mortality cost decreased.
Population Aging and Health Care Spending in Japan: Public- and Private-sector Responses
Population Aging, Intergenerational Transfers and the Macroeconomy, 2007
In many industrialized countries life expectancy at birth is rapidly approaching 80 years. Since the early 1980s Japan's life expectancy at birth has been at the highest level in the world. Despite their high health status, however, the Japanese people pay relatively little for medical care by international standards (Campbell and Ikegami 1998; Jeong and Hurst 2001; Imai 2002). In 2002, for example, Japan's total medical spending as a share of GDP was 7.9 percent, below the OECD average of 8.6 percent.
Issues in Japanese health policy and medical expenditure
2004
This paper first discusses the past patterns of the national medical care expenditure and its future path. About 30 percent of the past growth was due to population aging and the remaining 70 percent was due to technological change. The medical expenditure is expected to increase by about 20 percent in 20 years due to population aging. The latter half of the paper focuses on a reform plan of the health insurance for the elderly and presents some policy recommendations. One of the most serious problems in the health care market is that virtually no agents evaluate the quality of medical services or help improve it. It has not been clarified whether the rising medical costs are the result of waste or of necessity. Reform should attempt to make insurers play a more active role in the health care market as informed agents of patients. Dramatic outsourcing of the health insurance business to the private sector should be promoted. JEL classification numbers: I18, I11, H51
Aged-Care Support in Japan: Perspectives and Challenges
2004
Global aging experts are beginning to express grave concern about the extent of medical and social services that will be demanded in years to come by a growing but increasingly frail older population. It is in this context that long-term care (LTC) benefits become an important public policy issue with extraordinary fiscal implications as the world ages. This paper explores economic aspects of the market for long term care with a special focus on Japan. First, we describe the LTC system in Japan as presently implemented, and we highlight some aspects of the program that are novel and potentially of interest to other countries seeking models for long-term care provision. Next we discuss alternative projections of Japanese LTC utilization and costs. Finally, since Japan appears likely to experience important shortfalls in LTC in the future, we discuss whether such services might be more efficiently organized and financed under alternate forms of provision.