Population aging is expected to increase long-term care (LTC) costs in both Japan and Sweden. This study projected LTC costs for 2010 through 2040 for different assumptions of population change, LTC need by age group and gender, and LTC provided per level of need and cost in Japan and Sweden. Population data were taken from the official national forecasts. Needs projections were based on epidemiological data from the Nihon University Japanese Longitudinal Study of Aging and the Swedish Survey of Living Conditions. Data on LTC provision by need and cost were taken from nine Japanese municipalities collected by assessments in the LTC insurance system and from surveys in eight Swedish municipalities. Total initial costs were calibrated to official national figures. Two projections based on two different scenarios were made for each country from 2010 to 2040. The first scenario assumed a constant level of need for LTC by age group and gender, and the other assumed a continuation of the present LTC need trends until 2025. For Japan, this resulted in a projected cost increase of 93% for the one and 80% for the other; for Sweden it was 52% and 24%, respectively. The results reflected differences in population aging and health development.
CampbellJIkegamiN. Long-term insurance comes to Japan. Health Aff2000; 19: 26–39.
2.
Hiraoka K. Long-term Care Insurance and Welfare Mix in Japan [Ochanomizu Joshi Daigaku Jinbunkagaku Kiyo]. Tokyo, Japan: Ochanomizu University; 2001. Ochanomizu University Studies in Art and Culture; vol 54, 133–147.
3.
TsutsuiTMuramatsuN. Care needs certification in the long-term care insurance system of Japan. J Am Geriatr Soc2005; 53: 522–527.
4.
LagergrenM. The systems of care for frail elderly persons: the case of Sweden. Aging Clin Exp Res2002; 14: 252–257.
5.
LagergrenMSjölundB-MFagerströmCet al.Horizontal and vertical target efficiency—a comparison between users and non-users of public long-term care in Sweden. Ageing Soc2012; 34: 700–719.
6.
Masuda M. Kaigohoken minaosi no soten [Standpoints along the reforming of Long-Term Care Insurance]. Kyoto, Japan: Horitsubunkasha; 2003.
7.
Mitchell O, Piggott J, Shimizutani S. Aged-care Support in Japan: Perspectives and Challenges. NBER (National Bureau of Economic Research) Paper Series. Cambridge, MA: National Bureau of Economic Research; 2004.
8.
Shimizutani S. The Future of Long-term Care in Japan. RIETI Discussion Paper Series 13-E-064. Tokyo: The Research Institute of Economy, Trade and Industry; 2013.
9.
LagergrenMKurubeNSaitoY. Long term care in Japan and Sweden: a comparison of target population, needs and services provided from 2000–2010. J Gerontol Geriatr Research2016; 5: 331, . doi:10.4172/2167-7182.1000331.
10.
Lagergren M, Kurube N, Saito Y. Cost trends in long term care in Japan and Sweden over the period 2000 to 2010 [published online ahead of print August 18, 2016]. J Popul Aging. doi:10.1007/s12062-016-9155-1.
11.
Maeda N. Kenko chojyu no shakaiteki kouka no shisan—2020-2050 nen no kaigo kosuto henka shyumireshon no kekka [Simulation of social effect of health longevity: Result of simulation of care cost changes during 2020-2050]. Kisoken repoto, Nisse kiso kenkyujyo [NLI Report, Nissei Fundamental Research Institute]. Tokyo, Japan: Nissei Fundamental Research Institute; 2015.
12.
Nakasawa M, Sakai S, Sato J. Kigohiyou no choukisuikei [Long-term estimates of LTC costs]. Daiichikai jizoku kanou na kaigo ni kansuru kenkyukai [First study group on sustainable long-term care]. Tokyo, Japan: Zaimusho [Ministry of Finance]; 2014.
13.
Sakai S, Sato J, Nakazawa M. Kaigosouhiyo no choukisuikei [Total long-term estimates of LTC costs]. KIER Discussion Paper Series, No. 1504. Kyoto, Japan: Kyoto daigaku Keizai kenkyujyo [Kyoto University Research Institute of Economics]; 2015.
14.
Ueda J, Horiuchi Y, Tsutsui T. Iryo kaigohiyo no choukisuikei to shorai no rodo jyuyo: 2008 nendo no kokumin iryohi tou wo fumaeta suikei [Long-term estimates of the health and long-term care and demand of labour]. Kyoto, Japan: Kyoto daigaku Keizai kenkyujyo [Kyoto University Research Institute of Economics]; 2011. KIER Discussion paper Series, No. 1017.
15.
Ueda J. Dougakuteki kontororu ka no zaiseisesaku [Financial policy under dynamic control]. Tokyo, Japan: Iwanami; 2012.
16.
Nozaki M, Kashiwase K, Saito I. Health Spending in Japan: Macro-fiscal Implications and Reform Options. Tokyo, Japan: International Monetary Fund, Asia and Pacific Department and Fiscal Affairs Department; 2014. IMF Working Paper WP/14/142.
17.
OECD. Projecting OECD Health and Long-Term Care Expenditures: What Are The Main Drivers? Paris, France: OECD; 2006. Economics Department Working Papers No. 477.
18.
Comas-Herreras A, Wittenberg R, eds. European Study of Long-term Expenditure. PSSRU, LSE Health and Social Care. London, UK: London School of Economics; 2003.
19.
European Commission. 2015 Aging Report—Economic and Budgetary Projections for the 28 EU Member States (2013–2060). Luxembourg: European Commission; 2015.
Baumol W, Bowen W. Performing Arts, The Economic Dilemma: A Study of Problems Common to Theater, Opera, Music, and Dance. New York, NY: Twentieth Century Fund; 1966.
22.
Swedish Agency for Health and Care Services Analysis. Hemtjänst, vård- och omsorgsboende eller mitt emellan? [Home help, institutional care or something in between?]. Stockholm: Swedish Agency for Health and Care Services Analysis; 2015. Report 2015:8.
23.
Olivares-TiradoPTamiyaNKashiwagiMKashiwagiK. Predictors of the highest long-term care expenditures in Japan. BMC Health Serv Res2011; 11: 103, . doi:10.1186/1472-6963-11-103.
24.
Mitchell O, Piggott J, Shimizutani S. Developments in Long-term Care Insurance in Japan. Sydney, Australia: Centre for pensions and superannuation, University of New South Wales, Australia; 2007. CPS discussion papers 10/2007.
25.
YongVSaitoY. Are there education differentials in disability and mortality transitions and active life expectancy among Japanese older adults. Findings from a 10-year prospective cohort study. J Gerontol Ser B: Psychol Sci Soc Serv2012; 67(3): 343–353.
26.
KatzSFordABMoskowitzRWJacksonBAJaffeMW. Studies of illness in the aged. J Am Med Assoc1963; 185: 914–919.
27.
Statistics Sweden. Hälsoindex för den svenska befolkningen [A health index for the Swedish population]. Stockholm, Sweden: Statistics Sweden; 1992.
