title: In-depth descriptive analysis of trends in prevalence of long-term care in Japan.
abstract: BACKGROUND
  Long-term care (LTC) insurance was introduced in Japan in 2000. Herein, we describe the trends in demand for LTC, using age-standardized and level-specific rates of entitlement and utilization of LTC at national and prefectural levels.
  
  
  METHODS
  We analyzed LTC data from 2002-2005 to examine: (i) the influence of population aging, calculating crude and age-standardized entitlement and utilization rates; (ii) the relation between baseline entitlement rate and increase in the rate over this 3-year period; and (iii) differences in increases in entitlement rate between low and high care levels.
  
  
  RESULTS
  The entitlement and utilization rates increased even after adjustment for age; approximately two-thirds of the increase was not due to population aging. Variations in the entitlement rates among prefectures did not decrease (coefficient of variance was 0.12 in 2002 and 0.11 in 2005), and there was no significant correlation between baseline entitlement rates and the later increases among prefectures (r = -0.20, P = 0.19). The increase in entitlement rate was larger for low than for high care levels (31% vs 6%), and those for low and high care levels were weakly correlated.
  
  
  CONCLUSIONS
  This study suggested that a large part of the increase in LTC demand could not be explained by population aging, and the increase did not result from equalization of LTC services across the country. In addition, it seems that the demands of low and high care levels depend on different factors. The increase in LTC demand should be monitored carefully to identify underlying factors and to ensure sustainability of the system.
authors.affiliation: Department of Epidemiology, National Institute of Public Health, Wako, Saitama, Japan. fukuday@yamaguchi-u.ac.jp
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Fukuda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakao
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yahata
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Imai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006291:Health Policy; D006299:Health Services for the Aged / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D006304:Health Status; D006801:Humans; D007353:Insurance, Long-Term Care / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D007564:Japan / Q000453:epidemiology; D008134:Long-Term Care / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D011157:Population Dynamics; D015995:Prevalence