The Challenge of Sustaining Long-term Care in Aging Societies: Lessons From Japan and Spain; Comment on “Financing Long-term Care: Lessons From Japan”

Del Pozo-Rubio, Raúl; Jiménez-Rubio, Dolores

doi:10.15171/ijhpm.2019.143

The Challenge of Sustaining Long-term Care in Aging Societies: Lessons From Japan and Spain; Comment on “Financing Long-term Care: Lessons From Japan”

Document Type : Commentary

Authors

¹ Faculty of Social Sciences, University of Castilla-La Mancha, Cuenca, Spain

² Department of Applied Economics, Faculty of Economics and Business Sciences, University of Granada, Granada, Spain

10.15171/ijhpm.2019.143

Abstract

This article compares the provision of long-term care (LTC) in Japan and Spain, two countries with similar demographic structures but which address the provision of LTCs in very different ways. Both countries provide universal LTC. However, Japan has developed a generous benefit package of formal services for dependents to alleviate the care burden on the family, but provides no cash benefits. In Spain, on the other hand, cash allowances are the norm rather than the exception in the practical implementation of LTC services. After discussing the necessary delineation of LTC in response to future sociodemographic challenges, we discuss LTC system characteristics and the recent cost containment reforms implemented in Japan and Spain. Finally, we consider the lessons that may be drawn from each country’s experience and the reforms that must be undertaken in order ensure the sustainability of LTC provision in other countries with incipient or more developed LTC systems. In addition, since Japan and Spain are both faced with challenging demographic projections, it is important for each country to learn from the other’s initiatives and reforms.

Keywords

References

Ikegami N. Financing long-term care: lessons from Japan. Int J Health Policy Manag. 2019;8(8):462-466. doi:10.15171/ijhpm.2019.35

OECD. Health at a Glance. http://www.oecd.org/health/health-at-a-glance-19991312.htm. Published 2017.

Ortega-Ortega M, Montero-Granados R, Jiménez-Aguilera JD. Differences in the economic valuation and determining factors of informal care over time: the case of blood cancer. Gac Sanit. 2018;32(5):411-417. doi:10.1016/j.gaceta.2017.02.006

Albarrán Lozano I, Alonso González P, Bolancé Losillas C. [A comparison of the Spanish, the French and the German valuation scales to measure dependency and public support for people with disabilities]. Rev Esp Salud Publica. 2009;83(3):379-392. doi:10.1590/s1135-57272009000300004

United Nations, Department of Economic Social Affairs. World population ageing 2017: highlights. New York: United Nations; 2017.

World Health Organization (WHO). World Report on Ageing and Health. Geneva: WHO; 2015.

Colombo F, Nozal AL, Mercier J, Tjadens F. OECD health policy studies help wanted? Providing and paying for long-term care. OECD Publishing; 2011.

OECD Health Statistics 2019. https://stats.oecd.org/Index.aspx?ThemeTreeId=9.

Official Bulletin State. Act 39/2006 of 14th December on Promotion of Personal Autonomy and Assistance for Persons in a Situation of Dependency 2006.

Council of Europe. Recommendation No. R (98) 9 of the Committee of Ministers to member states concerning long-term care. Committee of Ministers of Council of Europe; 1998.

Economic and Social Council of Spain. Memoria sobre la situación socioeconómica y laboral de España 2012. Economic and Social Council of Spain; 2013.

Del Pozo-Rubio R, Pardo-García I, Escribano-Sotos F. [The co-payment of the dependence from the structural reform of 2012 in Spain]. Gac Sanit. 2017;31(1):23-29. doi:10.1016/j.gaceta.2016.09.003

Montserrat Codorniú J, Montejo Sarriás I. Análisis de las medidas introducidas en la Resolución de 13/7/2012. Actas de la Dependencia Fundación Caser; 2012:6.

Del Pozo-Rubio R, Jiménez-Rubio D. Catastrophic risk associated with out-of-pocket payments for long term care in Spain. Health Policy. 2019;123(6):582-589. doi:10.1016/j.healthpol.2019.03.016

Oliva-Moreno J, Peña-Longobardo LM, Vilaplana-Prieto C. An estimation of the value of informal care provided to dependent people in Spain. Appl Health Econ Health Policy. 2015;13(2):223-231. doi:10.1007/s40258-015-0161-x

Kerpershoek L, de Vugt M, Wolfs C, et al. Needs and quality of life of people with middle-stage dementia and their family carers from the European Actifcare study. When informal care alone may not suffice. Aging Ment Health. 2018;22(7):897-902. doi:10.1080/13607863.2017.1390732

Oliva-Moreno J, Trapero-Bertran M, Peña-Longobardo LM, Del Pozo-Rubio R. The valuation of informal care in cost-of-illness studies: a systematic review. Pharmacoeconomics. 2017;35(3):331-345. doi:10.1007/s40273-016-0468-y

Van Houtven CH, Norton EC. Informal care and health care use of older adults. J Health Econ. 2004;23(6):1159-1180. doi:10.1016/j.jhealeco.2004.04.008

Costa-Font J, Jimenez-Martin S, Vilaplana C. Does long-term care subsidization reduce hospital admissions and utilization? J Health Econ. 2018;58:43-66. doi:10.1016/j.jhealeco.2018.01.002

Ortega-Ortega M, Del Pozo-Rubio R. Catastrophic financial effect of replacing informal care with formal care: a study based on haematological neoplasms. Eur J Health Econ. 2019;20(2):303-316. doi:10.1007/s10198-018-0998-7

Mestheneos E, Triantafillou J. Supporting family carers of older people in Europe-The Pan-European background report. Vol 1. Siglo del Hombre Editores; 2005.

Lehnert T, Günther OH, Hajek A, Riedel-Heller SG, König HH. Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment. Eur J Health Econ. 2018;19(9):1213-1223. doi:10.1007/s10198-018-0968-0

Peña-Longobardo LM, Oliva-Moreno J, García-Armesto S, Hernández-Quevedo C. The Spanish long-term care system in transition: Ten years since the 2006 Dependency Act. Health Policy. 2016;120(10):1177-1182. doi:10.1016/j.healthpol.2016.08.012