The impact evaluation of reform of the national long-term care insurance system

2022 Fiscal Year Final Research Report

• Project/Area Number: 17H02605
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Social welfare and social work studies
• Research Institution: Tokyo Metropolitan University
• Principal Investigator: Sugihara Yoko 東京都立大学, 都市環境科学研究科, 教授 (80311405)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: 介護保険制度 / 政策評価 / サービス利用 / 在宅医療 / 介護負担 / 社会的支援 / 社会的排除 / 介護人材

Outline of Final Research Achievements

This study investigated the impacts of recent reforms to the long-term care insurance system on older adults and their caregivers. The main findings are as follows. The increase in the co-payment ratio for long-term care service use fees has curtailed service use among 20%-payers who were certified as care-level 4 or higher. Approximately 20% of primary caregivers of older adults in care-level 1 or 2 wish to be admitted to a nursing home, and older adult's ADL dependencies and problematic behaviors of dementia, and caregiver's age and economic status were related to their desire for admission. Use of home health care services increased positive feelings of caregivers providing medical care. Problematic behaviors of dementia and high co-payment rates for service fees were associated with unmet needs for service utilization, and unmet needs worsened caregiver's mental health. The percentage of those who positively evaluate the long-term care insurance system has decreased over time.

Free Research Field

高齢者福祉政策

Academic Significance and Societal Importance of the Research Achievements

介護保険制度の持続可能性を担保するための改定が行われているが，改定により生じる問題を把握することは，制度の効果的な実施を検討する上で有用な資料となる。本研究は，介護保険サービス利用料の自己負担割合引上げとサービス利用抑制との関連，特養入所要件から除外された要介護1・2における入所希望とその関連要因，医療ニーズを有する高齢者を在宅で介護する家族に有用な支援，介護サービスの未充足ニーズの状況とその関連要因や影響，介護保険制度や介護保険料への高齢者の評価，高齢者や介護者の社会的孤立や社会的支援の状況，介護サービス事業所や介護労働者への支援策等を明らかにし，今後の介護施策の検討に資する知見を得た。