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Healthcare costs for the elderly in Japan: Analysis of medical care and long-term care claim records

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  • Naomi Akiyama
  • Takeru Shiroiwa
  • Takashi Fukuda
  • Sachiyo Murashima
  • Kenshi Hayashida

Abstract

Background: The population is aging rapidly in many developed countries. Such countries need to respond to the growing demand and expanding costs of healthcare (HC) for the elderly. Therefore, it is important to investigate the factors correlating such HC costs. In Japan, HC is composed of two sections, namely medical care (MC) and long-term care (LTC). While many studies have examined MC and LTC costs on their own, few studies have conducted comprehensive investigations of HC costs. The aim of this study is to examine the risk factors that influence HC costs for the elderly who enroll in the LTC insurance system in Japan. Methods: The inclusion criteria in the present study are as follows: being 65 years of age, or older; certified eligibility for, and use of services offered by the LTC insurance system at home or in an institutional setting in December 2009; and being covered by the National Health Insurance (NHI) system. MC and LTC insurance data were obtained from claim records for the elderly in July and December of 2007, 2008, and 2009 (i.e., a total of six survey points). Panel data, per subject, were constructed using MC and LTC claim records. The sample included 810 subjects and 4029 observations. Results: We estimated a regression equation with a censored dependent variable using a Tobit model. Significant associations between MC or LTC costs and interaction terms (household composition × seasonal effects) were investigated. MC costs significantly decreased and LTC costs significantly increased among subjects living alone during winter. Income level was also a positive determinant of MC costs, while eligibility level was a positive determinant of LTC costs. Conclusions: We recommend that the health policy for the elderly focus more on seasonal effects, household composition, and income level, as well as on eligibility level.

Suggested Citation

  • Naomi Akiyama & Takeru Shiroiwa & Takashi Fukuda & Sachiyo Murashima & Kenshi Hayashida, 2018. "Healthcare costs for the elderly in Japan: Analysis of medical care and long-term care claim records," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-15, May.
  • Handle: RePEc:plo:pone00:0190392
    DOI: 10.1371/journal.pone.0190392
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    References listed on IDEAS

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    1. Van Houtven, Courtney Harold & Norton, Edward C., 2004. "Informal care and health care use of older adults," Journal of Health Economics, Elsevier, vol. 23(6), pages 1159-1180, November.
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    1. Masashige Saito & Naoki Kondo & Jun Aida & Junko Saito & Hisataka Anezaki & Toshiyuki Ojima & Katsunori Kondo, 2021. "Differences in Cumulative Long-Term Care Costs by Community Activities and Employment: A Prospective Follow-Up Study of Older Japanese Adults," IJERPH, MDPI, vol. 18(10), pages 1-11, May.
    2. Hiranya Sritart & Hiroyuki Miyazaki & Sakiko Kanbara & Takashi Hara, 2020. "Methodology and Application of Spatial Vulnerability Assessment for Evacuation Shelters in Disaster Planning," Sustainability, MDPI, vol. 12(18), pages 1-22, September.
    3. Batabyal, Amitrajeet & Higano, Yoshiro & Nijkamp, Peter, 2018. "Introduction to Disease, Human Health, and Regional Growth and Development in Asia," MPRA Paper 90266, University Library of Munich, Germany, revised 26 Nov 2018.

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