Journal of Gerontological Nursing

Public Policy 

Long-term Care Insurance in Japan: Implications for U.S. Long-term Care Policy

Susan Crocker Houde, PhD, APRN, BC; Ramraj Gautam, MA; Ichiro Kai, MD, MPH

Abstract

The purpose of this article is to review the long-term care insurance program in Japan and the present system of payment of long-term care services in the United States. The long-term care insurance system in Japan was implemented in 2001 for the purpose of promoting independence in older adults with functional disability. It reimburses for both home and institutional care. Several concerns expressed about the Japanese system include increasing applications for nursing home placement, lower use of home care services than anticipated, limited coverage for disabilities for those under 65, regional variations in service, educational preparation for case managers, and access to care for older adults. Revisions to the Japanese system and implications for U.S. long-term care policy are discussed.

Abstract

The purpose of this article is to review the long-term care insurance program in Japan and the present system of payment of long-term care services in the United States. The long-term care insurance system in Japan was implemented in 2001 for the purpose of promoting independence in older adults with functional disability. It reimburses for both home and institutional care. Several concerns expressed about the Japanese system include increasing applications for nursing home placement, lower use of home care services than anticipated, limited coverage for disabilities for those under 65, regional variations in service, educational preparation for case managers, and access to care for older adults. Revisions to the Japanese system and implications for U.S. long-term care policy are discussed.

ABSTRACT

The purpose of this article is to review the long-term care insurance program in Japan and the present system of payment of long-term care services in the United States. The long-term care insurance system in Japan was implemented in 2001 for the purpose of promoting independence in older adults with functional disability. It reimburses for both home and institutional care. Several concerns expressed about the Japanese system include increasing applications for nursing home placement, lower use of home care services than anticipated, limited coverage for disabilities for those under 65, regional variations in service, educational preparation for case managers, and access to care for older adults. Revisions to the Japanese system and implications for U.S. long-term care policy are discussed.

ABOUT THE AUTHORS

Dr. Houde is Professor and Director of the Master’s Program, University of Massachusetts Lowell, Department of Nursing. Mr. Gautam is a PhD candidate, and Dr. Kai is Professor, Department of Social Gerontology, School of Health Sciences and Nursing, University of Tokyo, Japan.

Address correspondence to Susan Crocker Houde, PhD, APRN, Department of Nursing, 3 Solomont Way, Suite 2, Lowell, MA 01854; e-mail: Susan_Houde@uml.edu.

Authors

Dr. Houde is Professor and Director of the Master’s Program, University of Massachusetts Lowell, Department of Nursing. Mr. Gautam is a PhD candidate, and Dr. Kai is Professor, Department of Social Gerontology, School of Health Sciences and Nursing, University of Tokyo, Japan.

Address correspondence to Susan Crocker Houde, PhD, APRN, Department of Nursing, 3 Solomont Way, Suite 2, Lowell, MA 01854; e-mail: Susan_Houde@uml.edu.

10.3928/00989134-20070101-04

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