Evidence Based Analysis of Long-Term Care Policy

2022 Fiscal Year Final Research Report

• Project/Area Number: 18H00861
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Basic Section 07050:Public economics and labor economics-related
• Research Institution: The University of Tokyo
• Principal Investigator: Iizuka Toshiaki 東京大学, 大学院経済学研究科(経済学部), 教授 (00406810)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 介護予防 / 垂直統合 / ケアマネ / EBPM / 介護政策 / 費用対効果 / 行政データ

Outline of Final Research Achievements

We conducted the following two research projects. Since Kaigo DB became available during the research period, I restructured the projects, and revised ones are underway.
[Issue 1] We analyzed the impacts of vertical integration (VI) of care managers (CMs) and service providers on the costs and outcomes of long-term care (LTC) services using individual-level claims data and ownership information. We found that VI CMs are more likely to create care plans that include services provided by co-owned providers.
[Issue 2] Using Kaigo DB, we examined the impact of additional preventive LTC services on LTC expenditure and health outcomes. Preventive services significantly increased at the threshold between AR1 and AR2 care levels, but we found no significant difference in care outcomes in terms of care minutes in the following year.

Free Research Field

医療経済学

Academic Significance and Societal Importance of the Research Achievements

近年、わが国の公的介護費用は劇的に増加し、2030年には約20兆円に達するとされ、効率的な介護政策の実現はまったなしである。課題１では、ケアマネと介護事業者の垂直統合のメリットとデメリットを定量的に把握した。わが国では、同一事業者がケアマネと介護サービスを実施できるが、補完的なサービスの垂直統合は不要なサービスの提供等につながる危険性がある。課題２では、介護予防サービスの費用対効果を分析した。介護予防は、高齢者が介護を必要とせず自立した生活を送れるよう、早期の予防策を打つことを目的とするが、その費用対効果に関する研究は少ない。いずれも効率的な介護の実現に資する極めて重要な研究課題である。