Japan: Universal Health Care at 50 years 4 Population ageing and wellbeing: lessons from Japan's long-term care insurance policy
Japan: Universal Health Care at 50 years 4 Population ageing and wellbeing: lessons from Japan's long-term care insurance policy
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DOI：
10.1016/s0140-6736(11)61176-8
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发表时间：
2011-09-24
期刊：
影响因子：
168.9
通讯作者：
Campbell, John Creighton
中科院分区：
文献类型：
--
作者：
Tamiya, Nanako;Noguchi, Haruko;Campbell, John Creighton
由于预期寿命长和出生率低，日本人口正在迅速老龄化，而对老年人的传统支持正在受到侵蚀。为此，日本政府于2000年启动了强制性公共长期护理保险（LTCI），以帮助老年人过上更独立的生活并减轻家庭照顾者的负担。 LTCI 按照社会保险原则运作，无论收入或家庭状况如何都提供福利；它在承保范围和福利方面都异常慷慨。只提供服务，不提供现金津贴，接受者可以选择他们的服务和提供者。对计划启动前后的全国调查数据的分析显示，家庭以较低的成本更多地使用正规护理，但护理人员的福祉结果好坏参半。该系统成功面临的挑战包括对家庭护理的不满、为家庭护理人员提供必要的支持以及财政可持续性。日本的长期护理战略可以为其他国家提供经验教训。
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.