4. Implementation of the long-term care insurance system
With the efforts made by people involved (municipalities, service facilities, etc.), the system is generally been implemented smoothly without any big confusion, and there are good effects such as the increase in the number of service supply.
Also, from October 2000, the reception of insurance premiums by elderly persons has begun. This system is going well without any big confusion with efforts made by municipalities.
(1) In-home service use
Monthly average in 1999 *1 | November 2000 *2 | May, 2001 *2 | |
Home-visit long-term care | 3,550,000 | 5,390,000(52% over) | 6,450,000(82% over) |
Commuting long-term care | 2,500,000 | 3,400,000(36% over) | 3,840,000(54% over) |
Short stay | 918,000 days | 849,000 days(7% decrease) *3 | 1,092,000 days(19% over) *3 |
Group home for the elderly with dementia | 266 place(Number of operating cost subsidies in 1999) | 870 place(March, 2001) | 1,312 place(September, 2000) |
*1 | The figures for home-visit long-term care, commuting long-term care and short stay are taken from autonomy data which is used as the basis for the FY 2000 Map of health and social welfare for the elderly. |
*2 | Sum of past benefit payments by federations of National Health Insurance Association. |
*3 | Past benefit payments by federations of National Health Insurance Association do no include service use replacement (measurement to replace the remainder of home-visit commuting service benefits to short stay services). Therefore, the data above has been calculated from the results of surveys conducted by 108 insurers. |
Persons whose use of service increased | Persons whose use of service is about the same as before | Persons whose use of service decreased |
67.5% | 14.8% | 17.7% |
Note: | The change in the amount of service use in March 2000 and July 2000 by 1,263 persons living in definite municipalities (108 Insurers). |
Among these people (1,263 people), only 32 people (2.5%) replied that they 'decreased the amount of service because the users' cost sharing is too high'. Nearly 70% of past service users increased their use of service with the implementation of the long-term care insurance system.
According to a survey conducted by autonomies, new users of service increased from 30% to 50% with the implementation of the long-term care insurance system
Local Government | Ishikawa-cho, Fukushima prefecture | Yokohama-city | Nagoya-city | Tottori prefecture | Tsuyama-city, Okayama prefecture |
Rate of increase | 48.2% | 30.9% | 29.5% | 47.1% | 49.2% |
Support required | Care level 1 | Care level 2 | Care level 3 | Care level 4 | Care level 5 | Average |
54.2% | 37.5% | 42.6% | 43.7% | 43.9% | 44.6% | 43.2% |
Note: | Survey of 8,323 people in definite municipalities (106 insurers) (Care plan random sampling method. In principle, survey on services provided in July 2000) |
(a) | With the basic concept to put emphasis on long-term care at home, limit for benefits will be set at a level much higher than the present service standard. |
(b) | The actual ratio of usage will be determined by the person's needs and amount of service supply. With the fixation of the system and increase in service supplies, it is estimated to increase in the future. |
(c) | In-home service usage rate in comparison with the limit for benefits is estimated to be approximately 33% in the FY2000 budget. This includes persons who do not use the service at all. 43.2% in the above table is the percentage of those who use the service. Therefore, the rate of in-home service usage is estimated to be around the same as before. |
(2) Situation of long-term care service facilities
April, 2000 | April, 2002 | |
Home-visit long-term care | 9,185 | 15,008(63% increased) |
Residence long-term care assistance | 19,466 | 23,321 (19% increased) |
(3) The state of long-term benefit payment (Provisional sum)
(Unit: 100 million) | |||||||||||||||||||||||||||||||||||||||||||||||||
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Notes 1: | Total of long-term care benefits except the 10% users' charge (90% charge) paid by federations of National Health Insurance Associations in the past. |
2: | Excludes charges municipalities pay directly, such as purchase allowance for welfare equipments and allowance for modifying house. |
3: | The brackets in the Total column are the figures adjusted for each month (30.4 days). |
(4) State of implementation at municipalities
1) | Number of insured persons, etc. (end of Mar. 2002) | ||
・ | Number of Category 1 insured persons (aged 65 or over) | 23,170,000 persons | |
・ | Number of certified persons requiring long-term care or support | 2,980,000 persons | |
2) | Number of service users | ||
・ | Number of residence long-term care(support) service recipients | 1,620,000 persons | |
・ | Number of long-term care service recipients at facilities | 670,000 persons | |
* | Reported in Mar. 2002 (service provided in Jan. 2002) |
3) | Premiums
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4) | Situation of user fee reduction measures (April 1, 2002)
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5) | Situation of long-term care protection and living support services enforced (April 1, 2002)
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(5) Long-term care insurance viewed from questionnaires
1) | Satisfaction of users' service
(Summary of answers from 11,181 people living in Aomori Prefecture, Toyama Prefecture, Ishikawa Prefecture, Hiroshima Prefecture, Shimane Prefecture, Kochi Prefecture, Kumamoto Prefecture, Chiba City and Wakayama City)
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2) | Emotional burden of usage fee
(Summary of answers from 6,668 people living in Fukushima Prefecture, Hiroshima Prefecture, Kochi Prefecture, and Kobe City)
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3) | Emotional burden of insurance premiums
(Summary of answers from 4,649 people living in Miyagi Prefecture, Fukushima Prefecture, Chiba City and Wakayama City)
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4) | Effects of the system
Replies of care takers (family) living in Miyagi Prefecture
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