[The influence of a doctor's opinion on notification delay in the long-term care insurance system in Japan--a two year study].
Prompt notification of recognition of the need for nursing is necessary for smooth application of Long-term Care Insurance Services. The Long-term Insurance Act requires notification of applicants of certification within 30 days. However, recognition of the need actually may be delayed for various reasons. To explain the influence of investigation for certification and the doctor's opinion for notification delay, 38,285 applications were investigated for 2 years in a city close to Osaka. The investigation period was divided into two stages, the first stage (from July 2000 to June 2001) and the second stage (from July 2001 to June 2002). The notification rate of the recognition result within 30 days was 42.0% in the first stage, and it improved to 46.8% in the second stage. However, the approximate number of days required for investigation for certification improved from 10.5 to 10.3, and that for the doctor's opinion improved from 20.2 to 19.1. Thus the doctor's opinion is a rate-controlling factor for the notification. By the standard operating procedures of the city, a two-week period is needed to prepare the long-term care requirement certification, thus it is necessary to obtain the doctor's opinion within 15 days.
Ooe
Yosuke
Y
Clinical Research Institute, Osaka National Hospital.
D000368:Aged; D002568:Certification; D005104:Expert Testimony; D006299:Health Services for the Aged; D006801:Humans; D007353:Insurance, Long-Term Care; D007564:Japan; D009313:National Health Programs; D010820:Physicians; D013995:Time