[Critical appraisal of preventive care--from the perspective of health economics and policy].

I examined the effects and problems of preventive care (the New Preventive Benefit) that was introduced to Japan's public long-term care insurance system in 2006, reviewing official publications of the Ministry of Health, Labor and Welfare and Japanese government as well as Japanese and English empirical studies on preventive care, using five pillars as follows. Firstly, I briefly introduced my previous literature review of preventive care in 2006. Secondly, I show five important points and pitfalls concerning economic evaluation of health services. Thirdly, I reviewed Japanese articles and publications that analyzed economic effect of preventive care. Fourthly, I reviewed English review articles on the effect of fall-prevention programs that are most widely analyzed among several preventive care. Finally, I showed that the Ministry of Health, Labor and Wealth "deflated" the estimation of cost that can be incurred by preventive care in 5 years (from 2006 to 2011). Based on these analyses, there is not yet solid evidence that preventive care can decrease the total cost of long-term care.