title: Long-term care insurance in Japan: implications for U.S. long-term care policy.
abstract: The purpose of this article is to review the long-term care insurance program in Japan and the present system of payment of long-term care services in the United States. The long-term care insurance system in Japan was implemented in 2001 for the purpose of promoting independence in older adults with functional disability. It reimburses for both home and institutional care. Several concerns expressed about the Japanese system include increasing applications for nursing home placement, lower use of home care services than anticipated, limited coverage for disabilities for those under 65, regional variations in service, educational preparation for case managers, and access to care for older adults. Revisions to the Japanese system and implications for U.S. long-term care policy are discussed.
authors.affiliation: University of Massachusetts Lowell, Department of Nursing. Lowell, MA 01854, USA. Susan_Houde@uml.edu
authors.forename: Susan Crocker
authors.initials: SC
authors.lastname: Houde
authors.forename: Ramraj
authors.initials: R
authors.lastname: Gautam
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kai
mesh_terms: D000368:Aged; D003191:Comprehensive Health Care / Q000458:organization & administration; D006233:Persons with Disabilities; D004608:Eligibility Determination; D018166:Health Care Reform / Q000458:organization & administration; D006291:Health Policy / Q000191:economics / Q000331:legislation & jurisprudence; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006299:Health Services for the Aged / Q000458:organization & administration*; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D019458:Insurance Coverage; D007353:Insurance, Long-Term Care / Q000191:economics / Q000331:legislation & jurisprudence; D007564:Japan; D008484:Medicaid / Q000458:organization & administration; D006278:Medicare / Q000458:organization & administration; D009313:National Health Programs / Q000458:organization & administration; D009735:Nursing Homes / Q000458:organization & administration; D012051:Reimbursement Mechanisms; D014481:United States