The Effects of Changes in Accessibility for Long-term Care Services on the Disparities among the eligible of Long-term Care Insurance

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K04264
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Social welfare and social work studies
• Research Institution: Kanagawa University of Human Services (2019); Waseda University (2017-2018)
• Principal Investigator: Kawamura Akira 神奈川県立保健福祉大学, ヘルスイノベーション研究科, 教授 (10422198)
• Co-Investigator(Kenkyū-buntansha): 野口 晴子 早稲田大学, 政治経済学術院, 教授 (90329318)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 価格弾力性 / 介護レセプト / アクセシビリティ / 参入・退出

Outline of Final Research Achievements

We investigate the effects of the accessibility of long-term care (LTC) services for public LTC eligibility on the utilization of LTC services. Focusing on the copayment rate and geographical distribution of the LTC facilities, we evaluate the accessibility of LTC service and its consequence.
First, we estimated the price elasticity of LTC demand as a measure of accessibility for LTC services using monthly LTC insurance claims and vital statistics. We found that a 10%-point decrease in copayment rate would increase the monthly cost by 10.2 thousand yen and the price elasticity is found to be about -0.1.
We then assessed the geographical accessibility using information on the location of LTC service facilities. Notwithstanding the difficulty in obtaining consistent results to be interpreted, we were successful in accumulating information on how to construct the geographical database and identified problems for future research.

Free Research Field

医療経済学

Academic Significance and Societal Importance of the Research Achievements

我が国において2000年4月に介護保険制度が施行されて以降、高齢化の進展が介護サービス利用者増を促してきたと同時に、介護保険サービス供給も量的拡大が続いてきた。しかし、これら介護サービス市場の拡大は、必要な人に必要なサービスが行き届いていることを必ずしも意味しないことから、介護サービス利用者のサービスの利用しやすさ(アクセシビリティ)が実際のサービス利用にどう影響するかを研究課題とした。
今後も続く少子高齢社会の中でも公的介護保険財政の持続可能性を担保するためには、これらの基礎情報を得ることは必要不可欠である。