Estimating Potential Cost Containment through Provision of Unplanned Institutional Respite Services to Support Home-Based Care within Japan’s Long-Term Care Insurance System

Abstract

Background: Many informal caregivers providing at-home care to older family members want to continue serving as the primary caregiver if they get sufficient support. A key service enabling continued at-home care is access to unplanned respite care facilities for temporary institutional care on short notice and in emergencies. Methods: This study used city government survey results on service user satisfaction with the Japanese Long-Term Care Insurance (LTCI) system for a mid-sized, typical Japanese city. From this a range is estimated for the potential impact of improved easy access to unplanned respite care services. Combined with reimbursement rules and cost data from the Japanese LTCI system, this is used to calculate potential financial implications of improving access to unplanned respite care services for the city. Results: Through the enabling of continued at-home care provision, our study suggests increased access to unplanned respite care bed provision could likely save the city between 4.0% and 12.9% of total expenditures on long-term care benefits (between 393 million yen and 1.28 billion yen per year for Tsukuba City). Providing increased access to unplanned respite care service would be very helpful in both cost containment and reduction of burden and fear of caregivers globally. Conclusions: The model finds that increased ease of access to unplanned respite care services would both be welcome by informal caregivers and be cost effective within the Japanese LTCI system.