Longitudinal Evaluation Research for Public Long-term Care Insurance in Japan -Effect of Premium increase

点击翻译按钮获取中文摘要

To assess how an increase the premium fee for Japanese public long term care insurance (LTCI) affected their utilization of homecare services, we analyzed Electronic claim bill data and municipal records between April 2000 and February 2003 in one local city in Japan.Beneficiaries who used LTCI services at least one month during this term were selected from the claim bill database (N=1869). We calculated monthly average of service use amount and number of users for these 35 months. Stratifications by basic characteristics of beneficiaries (Care-Level, age, and sex), kind of services used were performed. On the insurance premium, we divided these terms into three terms (no premium, half-premium, and full-premium) and analyzed the effect of increase of premium.Though increase of premium had tentative negative effect for service use, number of users increased during these terms. Payment of premium may effect to encourage using LTCI as right of payers. However, the number of institutional care also incased during these terms. They may have been difficult to continue home care with bigger economic burden due to premium.Our results suggested that payment of premium was not so big burden generally and encourage the service use for relatively independent elderly. However, for the elderly who are seriously dependent the increase of economic burden may cause institutionalization.