Abstract

In Japan, under the Long-Term Care Insurance Act of 2018, the Integrated Facility for Medical and Long-Term Care was established as a new long-term care insurance facility into which Sanatorium Medical Facilities could be converted, and this conversion has taken place gradually; in this study, we compared the management policies between existing Sanatorium Medical Facilities and Integrated Facilities. We also examined the management policies of Geriatric Health Services Facilities. For the management policies of individual facilities, published data on the “Long-Term Care Service Information Publication System” website were used; the study included 142 Integrated Facilities, 245 Sanatorium Medical Facilities, and 237 Geriatric Health Services Facilities. The percentage of facilities in each facility group that included specific keywords was compared. There were no significant differences in the percentage of facilities including “Return,” “Long-term,” “Management,” “Care,” and “Coordination” in their management policies between Sanatorium Medical Facilities and Integrated Facilities. Compared with Geriatric Health Services Facilities, Sanatorium Medical Facilities had a significantly lower rate of including “Return” and a significantly higher rate of including “Long-term,” “Management,” “Care,” and “Coordination.” As seen from the above, the management policies of Sanatorium Medical Facilities were similar to those of Integrated Facilities, rather than Geriatric Health Services Facilities. When Geriatric Health Services Facilities and Integrated Facilities were compared as candidates for conversion from Sanatorium Medical Facilities, it was suggested that the barrier to entry is lower for the Integrated Facilities than for Geriatric Health Services Facilities in terms of necessity of major change in management policies.

Highlights

  • When Geriatric Health Services Facilities and Integrated Facilities were compared as candidates for conversion from Sanatorium Medical Facilities, it was suggested that the barrier to entry is lower for the Integrated Facilities than for Geriatric Health Services Facilities in terms of necessity of major change in management policies

  • Long-term care beds in Japan are defined under the Medical Care Act as beds primarily for hospitalization of patients requiring long-term care, and they have been operated separately as beds covered by medical insurance and beds covered by long-term care insurance since the Long-Term Care Insurance Act came into effect in 2000 (Ministry of Health, Labour and Welfare [MHLW], 2008b; MHLW, 2002)

  • As of December 31, 2019 the Japanese government has identified a total of 301 Integrated Facilities for Medical and Long-Term Care with a total of 18 931 beds, an average of 62.9 beds per facility (MHLW, 2020, May 1)

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Summary

Introduction

Long-term care beds in Japan are defined under the Medical Care Act as beds primarily for hospitalization of patients requiring long-term care, and they have been operated separately as beds covered by medical insurance and beds covered by long-term care insurance (hereafter referred to as “Sanatorium Medical Facilities”) since the Long-Term Care Insurance Act came into effect in 2000 (Ministry of Health, Labour and Welfare [MHLW], 2008b; MHLW, 2002). The government provided various support measures on personnel and facility standards so that existing Sanatorium Medical Facilities could be converted smoothly into “Geriatric Health Services Facilities.”. This was because Geriatric Health Services Facilities were numerically closest to existing Sanatorium Medical Facilities in terms of medical staffing standards and facility standards among the various long-term care insurance services existing at that time (MHLW, 2008c; MHLW, 2011). The actual operating deadline for Sanatorium Medical Facilities was extended for another six years from 2012, their conversion still did not progress, and this period was extended again for another six years from 2018 (MHLW, 2017; MHLW, 2018)

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