title: Impact of the elder abuse prevention and caregiver support law on system development among municipal governments in Japan.
abstract: OBJECTIVE
  Japan enacted the elder abuse law in April 2006. The present study was aimed to examine the progress of systems development and difficulties with implementing activities in municipal governments for dealing with elder abuse after the law.
  
  
  METHODS
  Between 11 and 22 December 2006 a paper questionnaire was sent to all 1840 Japanese municipalities and received 917 responses (49.8%). The municipalities were divided into three groups according the number of elder abuse management activities they had implemented: an advanced group (N=257), a middle group (N=348), and a less advanced group (N=312).
  
  
  RESULTS
  The law increased the implementation of activities related to reporting systems (46.2-49.1%) and activities for increasing awareness of elder abuse among service providers (30.7-35.8%). The most frequent activities with no plans for implementation were the establishment of intervention teams (43.7-55.5%) and multi-agency networks (47.7-64.2%). All groups reported difficulties carrying out home visits to investigate reported cases of abuse (53.6-61.5%) and difficulties approaching reported cases where there was resistance to outside support (42.4-76.6%).
  
  
  CONCLUSIONS
  The law was significant step in activities related to reporting systems and activities for increasing awareness among service providers. Further policy should address how to establish intervention teams and multi-agency networks, how to carry out home visits to investigate reports, and how to approach cases resistant to outside support.
authors.affiliation: Institute for Health Economics and Policy, 1-5-11 Nishishinbashi, Minato-ku, Tokyo 105-0003, Japan. mnakanishi-tky@umin.ac.jp
authors.forename: Miharu
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Hoshishiba
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Iwama
authors.forename: Tomoko
authors.initials: T
authors.lastname: Okada
authors.forename: Etsuko
authors.initials: E
authors.lastname: Kato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D017028:Caregivers / Q000331:legislation & jurisprudence*; D003430:Cross-Sectional Studies; D004552:Elder Abuse / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D006801:Humans; D007564:Japan; D009111:Local Government; D019221:Mandatory Reporting; D011795:Surveys and Questionnaires