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A gap in formal long-term care use related to characteristics of caregivers and households, under the public universal system in Japan: 2001–2010

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  • Tokunaga, Mutsumi
  • Hashimoto, Hideki
  • Tamiya, Nanako

Abstract

We investigated whether the universal provision of long-term care (LTC) under Japan's public system has equalized its use across households with different socio-economic characteristics, with a special focus on the gender and marital status of primary caregivers, and income. We used repeated cross-sectional data from national household surveys (2001, 2004, 2007, and 2010) and conducted multiple logistic regression analyses to obtain odds ratios of caregiver and household characteristics for service use, adjusting for recipients’ characteristics. The results showed that the patterns of service use have been consistently determined by caregivers’ gender and marital status over the period despite demographic changes among caregivers. The gap in service use first narrowed, then widened again across income levels after the global economic recession. The results indicate that the traditional gender-bound norms and capacity constraints on households’ informal care provision remained influential on decisions over service use, even after the universal provision of formal care. To improve equality of service utilization, the universal LTC system needs to meet diversifying needs of caregivers/recipients and their households, by overcoming barriers related to gender norms and economic disparity.

Suggested Citation

  • Tokunaga, Mutsumi & Hashimoto, Hideki & Tamiya, Nanako, 2015. "A gap in formal long-term care use related to characteristics of caregivers and households, under the public universal system in Japan: 2001–2010," Health Policy, Elsevier, vol. 119(6), pages 840-849.
    • Handle: RePEc:eee:hepoli:v:119:y:2015:i:6:p:840-849
    DOI: 10.1016/j.healthpol.2014.10.015
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    References listed on IDEAS

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    1. Lori D. Campbell & Anne Martin-Matthews, 2003. "The Gendered Nature of Men's Filial Care," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 58(6), pages 350-358.
    2. Hanaoka, Chie & Norton, Edward C., 2008. "Informal and formal care for elderly persons: How adult children's characteristics affect the use of formal care in Japan," Social Science & Medicine, Elsevier, vol. 67(6), pages 1002-1008, September.
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    Cited by:

    1. Rong Fu & Haruko Noguchi, 2019. "Moral hazard under zero price policy: evidence from Japanese long-term care claims data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 785-799, August.
    2. Plaisier, Inger & Verbeek-Oudijk, Debbie & de Klerk, Mirjam, 2017. "Developments in home-care use. Policy and changing community-based care use by independent community-dwelling adults in the Netherlands," Health Policy, Elsevier, vol. 121(1), pages 82-89.
    3. Tami Saito & Naoki Kondo & Koichiro Shiba & Chiyoe Murata & Katsunori Kondo, 2018. "Income-based inequalities in caregiving time and depressive symptoms among older family caregivers under the Japanese long-term care insurance system: A cross-sectional analysis," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-13, March.
    4. Narimasa Kumagai, 2017. "Distinct impacts of high intensity caregiving on caregivers’ mental health and continuation of caregiving," Health Economics Review, Springer, vol. 7(1), pages 1-14, December.
    5. Tokunaga, Mutsumi & Hashimoto, Hideki, 2017. "The socioeconomic within-gender gap in informal caregiving among middle-aged women: Evidence from a Japanese nationwide survey," Social Science & Medicine, Elsevier, vol. 173(C), pages 48-53.
    6. María Lisseth Morales Aliaga & Tomoko Ito & Takehiro Sugiyama & Timothy Bolt & Nanako Tamiya, 2021. "Association between Having Cancer and Psychological Distress among Family Caregivers Using Three Years of a Nationwide Survey Data in Japan," IJERPH, MDPI, vol. 18(19), pages 1-11, October.

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