The Impact of Home-Modification Service on the Functional Prognosis and Formal Care Use Under the Japanese Long-Term Care Insurance System

Posted: 26 Jun 2007

See all articles by Hideki Hashimoto

Hideki Hashimoto

University of Tokyo - Graduate School of Medicine

Haruko Noguchi

National Institute of Population & Social Security Research

Eiji Yano

Teikyo University - School of Medicine

Date Written: June 26, 2006

Abstract

This study purported to evaluate the impact of home modification service on the functional prognosis and formal long-term care service use under the Japanese public long-term care insurance. Theoretically, home modification is expected to prevent the frail elderly from fall accidents at home, and to help them maintain functional levels and independence. Since its introduction in the year 2000, the Japanese public Long-term insurance system (LTCI), mandatory for all the citizens without selection, and driven by local government insurers, covers home modification service as well as care at home and institutions. However, its empirical evaluation has been quite limited. Using electronic claim bill data with a complementary interview survey provided by a local government insurer, we evaluated whether the home modification service use affected functional prognosis and long-term care service utilization other than home modification one year after the service use. Considering the observational nature of the data, and the susceptibility to endogeneity problems, we used beneficiaries' ex ante preference to use modification service as an instrument. The analytic results did not support the expected benefit of home modification on the functional prognosis. LTCI service use was larger among those used home modification service, suggesting there seemed to exist service-provider induced demand. We discussed on the policy implication of the obtained results and possible policy change of the current LTCI in this country.

Keywords: home modification, elderly, long-term care insurance, functional prognosis

Suggested Citation

Hashimoto, Hideki and Noguchi, Haruko and Yano, Eiji, The Impact of Home-Modification Service on the Functional Prognosis and Formal Care Use Under the Japanese Long-Term Care Insurance System (June 26, 2006). iHEA 2007 6th World Congress: Explorations in Health Economics Paper, Available at SSRN: https://ssrn.com/abstract=996533

Hideki Hashimoto (Contact Author)

University of Tokyo - Graduate School of Medicine ( email )

Hongo 7-3-1
Bunkyo-ku
Tokyo, 1130033
Japan
81358413512 (Phone)
81358413512 (Fax)

Haruko Noguchi

National Institute of Population & Social Security Research ( email )

Hibiya Kokusai Building 6th Fl
2-2-3 Uchisaiwai-cho, Chiyoda-ku
Tokyo 100-0011, Chiyoda-ku
Japan
+81-3-3595-2989 (Phone)
+81-3-3595-2989 (Fax)

Eiji Yano

Teikyo University - School of Medicine ( email )

Department of Hygiene and Public Health
Hachiojishi, Tokyo, 192-0395
Japan

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