Inadequate coverage of needs of elderly patients by long-term care insurance or medical insurance: A Japanese survey study

• Material Type: 記事
• Title: Inadequate coverage of needs of elderly patients by long-term care insurance or medical insurance: A Japanese survey study
• Author Heading: Ishikawa Masaki; Otake Hiroshi; Kajii Eiji; Ishikawa Shizukiyo; Oe Katsunori
• Publication Date: 2025
• Publication Date (W3CDTF): 2025
• Periodical title: The Showa Medical University Journal
• No. or year of volume/issue: 37 2
• Volume: 37
• Issue: 2
• Pages: 91-100
• Publication date of volume/issue (W3CDTF): 2025
• Publication (Periodical Title): The Showa Medical University Society
• Text Language Code: en
• Subject Heading: Elderly; home care services; long-term care; insurance; personal satisfaction
• Target Audience: 一般
• DOI: 10.15369/smuj.37.2_91; https://doi.org/10.15369/smuj.37.2_91
• Access Restrictions: インターネット公開
• Related Material (URI): https://showa.repo.nii.ac.jp/records/2000794; https://www.jstage.jst.go.jp/article/smuj/37/2/37_91/_pdf; https://search.jamas.or.jp/link/ui/2026038672
• References: Self-Management Group Exercise Extends Healthy Life Expectancy in Frail Community-Dwelling Older Adults; https://cir.nii.ac.jp/crid/1050282677617435648; The Comparative Performance of For-Profit and Nonprofit Home Health Care Services in the US; https://cir.nii.ac.jp/crid/1360023716733350144; Integrated approach to prevent functional decline in hospitalized elderly: the Prevention and Reactivation Care Program (PReCaP); https://cir.nii.ac.jp/crid/1360023716989677056; Future Costs of Long-term Care in Japan and Sweden; https://cir.nii.ac.jp/crid/1360023720800851328; Improving long-term care provision: towards demand-based care by means of modularity; https://cir.nii.ac.jp/crid/1360023721037033600; Rural–urban differences in the prevalence of cognitive impairment in independent community-dwelling elderly residents of Ojiya city, Niigata Prefecture, Japan; https://cir.nii.ac.jp/crid/1360284918627255424; Long-term care-service use and increases in care-need level among home-based elderly people in a Japanese urban area; https://cir.nii.ac.jp/crid/1360285707151869824; Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan; https://cir.nii.ac.jp/crid/1360285711792987520; The relationship of community activities with cognitive impairment and depressive mood independent of mobility disorder in Japanese older adults; https://cir.nii.ac.jp/crid/1360292619141045120; Characteristics of care management agencies affect expenditure on home help and day care services: A population‐based cross‐sectional study in Japan; https://cir.nii.ac.jp/crid/1360301163965482112; Non-Profit and For-Profit Organizations in Home Care Services: https://cir.nii.ac.jp/crid/1360305192173428992; The TrueBlue model of collaborative care using practice nurses as case managers for depression alongside diabetes or heart disease: a randomised trial; https://cir.nii.ac.jp/crid/1360305193598002304; The Israeli long-term care insurance law: selected issues in providing home care services to the frail elderly; https://cir.nii.ac.jp/crid/1360305194697935360; Aged Care Service Delivery in Japan; https://cir.nii.ac.jp/crid/1360305194711033728; The distribution structure of medical and care resources based on regional characteristics throughout Japan in 2020; https://cir.nii.ac.jp/crid/1360305195947945344; Healthcare costs for the elderly in Japan: Analysis of medical care and long-term care claim records; https://cir.nii.ac.jp/crid/1360567187572351744; An overview of the role of government in the organisation and provision of health services in Japan; https://cir.nii.ac.jp/crid/1360586668480182400; The Effect of Home- and Community-Based Services on Social Engagement; https://cir.nii.ac.jp/crid/1360586670925470336; Factors affecting the entry of for-profit providers into a price regulated market for formal long-term care services: A case study from Japan; https://cir.nii.ac.jp/crid/1360848657436273920; Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan; https://cir.nii.ac.jp/crid/1360855568762793984; Does Person-Centered Care Improve Residents' Satisfaction With Nursing Home Quality?; https://cir.nii.ac.jp/crid/1360868142459780224; Does the public sector outperform the nonprofit and for‐profit sectors? Evidence from a national panel study on nursing home quality and access; https://cir.nii.ac.jp/crid/1360868143326700032; Commentary on long‐term care insurance and the market for aged care in <scp>J</scp>apan; https://cir.nii.ac.jp/crid/1360868144925257984; The long term care insurance law in Japan: impact on institutional care facilities; https://cir.nii.ac.jp/crid/1362262943860090368
• Data Provider (Database): 国立情報学研究所 : CiNii Research; https://cir.nii.ac.jp/
• Original Data Provider (Database): Japan Link Center; https://japanlinkcenter.org/top; 学術機関リポジトリデータベース; https://irdb.nii.ac.jp; Crossref; https://www.crossref.org

• Summary, etc.: In Japan, medical and long-term care services are provided by separate insurance systems. The elderly have multifaceted needs, and this study aims to identify gaps in services not adequately covered by these insurance policies and assess user satisfaction with the available services. A cross-sectional survey was conducted between April 2014 and December 2017, targeting 251 home healthcare service users in Japan. After excluding those with severe dementia or impairments, 95 service users and 156 caregivers participated. The survey included questions on service usage, satisfaction levels, unmet needs, and household information. Additionally, three care managers from different facilities were interviewed. The survey revealed a mismatch between the services provided and the needs of users. The most desired services were shopping for non-daily necessities and support for general outings, both of which were inadequately covered by the current insurance systems. Care managers noted that although no deficiencies were officially admitted, a more timely offering of household-specific services could prevent hospitalization due to declines in activities of daily living （ADL）. Certain home-based services desired by users are not fully covered by Japan’s long-term care or medical insurance systems. Addressing these gaps could improve the wellbeing of care recipients and caregivers while potentially reducing healthcare costs. However, delays in service provision due to the lack of a centralized system may decrease ADLs, increasing the risk of hospitalization.
• DOI: 10.15369/smuj.37.2_91
• Access Restrictions: インターネット公開
• Data Provider (Database): 科学技術振興機構 : J-STAGE; http://www.jstage.jst.go.jp

• Summary, etc.: In Japan, medical and long-term care services are provided by separate insurance systems. The elderly have multifaceted needs, and this study aims to identify gaps in services not adequately covered by these insurance policies and assess user satisfaction with the available services. A cross-sectional survey was conducted between April 2014 and December 2017, targeting 251 home healthcare service users in Japan. After excluding those with severe dementia or impairments, 95 service users and 156 caregivers participated. The survey included questions on service usage, satisfaction levels, unmet needs, and household information. Additionally, three care managers from different facilities were interviewed. The survey revealed a mismatch between the services provided and the needs of users. The most desired services were shopping for non-daily necessities and support for general outings, both of which were inadequately covered by the current insurance systems. Care managers noted that although no deficiencies were officially admitted, a more timely offering of household-specific services could prevent hospitalization due to declines in activities of daily living （ADL）. Certain home-based services desired by users are not fully covered by Japan’s long-term care or medical insurance systems. Addressing these gaps could improve the wellbeing of care recipients and caregivers while potentially reducing healthcare costs. However, delays in service provision due to the lack of a centralized system may decrease ADLs, increasing the risk of hospitalization.
• Source: S37_91.pdf （fulltext）; https://showa.repo.nii.ac.jp/record/2000794/files/S37_91.pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.15369/smuj.37.2_91; https://doi.org/10.15369/smuj.37.2_91
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 昭和医科大学 : 昭和医科大学学術業績リポジトリ