Abstract
Objectives: This study examined how healthcare costs might change by reducing long-term care needs among older Japanese people.Methods: A simulation model was constructed comprising two aging chains for independent and dependent people aged ≥65 years by sex. Changes in the base run from 2020 to 2040 were compared with those in two hypothetical scenarios: a 2% annual reduction in death rates (S1), and S1 plus a 2% annual reduction in the proportion of dependent people aged 65 years and in transition rates from the independent to dependent state for people aged ≥65 years (S2).Results: In the base run, the population increased by 13.0% for men and 11.3% for women, and the proportion of dependent people increased by 4.6% for men but decreased by 13.4% for women. The sum of medical and long-term care expenditure increased in the base run, S1, and S2 by 8.2, 27.4, and 16.4%, respectively, for men and women combined.Conclusions: Healthcare costs will increase as death rates fall, but the increase will be attenuated if the proportion of dependent people decreases.
Highlights
With a low mortality and a low birth rate, the Japanese population has been aging recently
An annual reduction of 2% (33% reduction in total by 2040) was used in the scenarios to show a clear contrast to the base run: Scenario 0: base run Scenario 1: 2% annual reduction in death rates Scenario 2: Scenario 1 plus a 2% annual reduction in the proportion of dependent people at age 65 and in transition rates from the independent state to the dependent state for people aged ≥65 years
From 2020 to 2040, the proportion of dependent people was projected to increase by 4.6% for men but decrease by 13.4% for women in the base run, to increase by 36.5% for men and by 3.3% for women in S1, and to increase by 2.4% for men but to decrease by 23.7% for women in S2
Summary
With a low mortality and a low birth rate, the Japanese population has been aging recently. In 2017, life expectancy was 81.09 years for men and 87.26 years for women [1], and the fertility rate was 1.43 [2]. In 2018, the population aged 65 years or older accounted for 28.1% of the total population [3] which is the highest in the world. National medical expenditure has increased over time, reaching 7.8% of gross domestic product in 2016 [4]. Japan is facing a growing burden in terms of healthcare costs that no other countries have ever encountered.
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