INTRODUCTION In 2000, Japan implemented a mandatory long-term care insurance system. With the rapid growth of the system, problems became apparent. Several critical alterations were made to long-term care insurance system, particularly with respect to integrated care. METHODS This paper elucidates the policy trends that led to the reforms of the long-term care insurance system, which included...

This paper reviews a decade of implementation of the public long-term care insurance (LTCI) program in Japan, which is now experiencing unprecedented pressure from its rapidly aging population. This overview of the program’s features focuses on the incentive mechanisms and diversity, and examines official future projections of LTCI costs and their accompanying assumptions. It also includes the ...

The textbook approach to insurance markets emphasizes the role of private information about risk in determining who purchases insurance. In the classic adverse selection model of Michael Rothschild and Joseph Stiglitz (1976), individuals with higher expected claims buy more insurance than those with lower expected claims, who may be out of the market entirely. This basic prediction of asymmetri...

It is challenging to change physicians' antimicrobial prescribing behaviour. Although antimicrobial prescribing is determined by contextual (e.g. a lack of guidelines), cultural (e.g. peer practice) and behavioural (e.g. perceived decision making autonomy) factors, most antimicrobial stewardship programmes fail to consider these factors in their approach. This may lead to suboptimal interventio...

The aim of this paper is to describe the process of building a multi-level intervention called the Enriched Opportunities Programme, the objective of which is to provide a sustainable activity-based model for people with dementia living in long-term care. It is hypothesised that five key elements need to work together to bring about a sustainable activity-based model of care. These elements are...

BACKGROUND Social networks are theorized as significant influences in the innovation adoption and behavior change processes. Our understanding of how social networks operate within healthcare settings is limited. As a result, our ability to design optimal interventions that employ social networks as a method of fostering planned behavior change is also limited. Through this proposed project, we...

Does long-term care insurance help purchasers preserve their assets and avoid Medicaid? The purpose of this issue brief is to explore the complex interaction of Medicaid and private long-term care insurance and highlight the policy implications for those who may "fall through the cracks" in their coverage.

The aim of this study was to estimate willingness to pay (WTP) for long-term care insurance (LTCI) and to explore the determinants of demand for LTCI in China. We collected data from a household survey conducted in Qinghai and Zhejiang on a sample of 1842 households. We relied on contingent valuation methods to elicit the demand for LTCI and random effects logistic regression to analyze the fac...

OBJECTIVES To assess the feasibility, validity and responsiveness of an individualized measure--goal attainment scaling-in long-term care. DESIGN Prospective descriptive study. SETTING One academic and three community-based long-term care facilities. SUBJECTS 53 nursing-home patients seen in consultation between July 1996 and June 1997. INTERVENTION Specialized geriatric medicine consul...