Catharina Klein
Research expert covering Japan
Long-term care in Japan - statistics & facts
Japan's population is experiencing a rapid aging trend. The number of elderly individuals has reached new record highs each year. 2025 will be the year when Japan will start to feel its age, as the baby boomer generation edges over 75 years old. Consequently, investment in the pension system, healthcare facilities, long-term care, and welfare will become more important. Currently, the Japanese government spends around 35 percent of general government expenses on social security, which includes costs for social welfare and health measures.
The increasing number of people requiring long-term care in Japan led to a long-term care budget leap from 2.9 trillion to over 3.7 trillion Japanese yen over the past decade. Thus, the demographic shifts in Japan will not only entail pressure on governmental spending but also bring about significant growth for service providers and related industries.
There are two categories: primary insured people aged 65 years and older and secondary insured people aged 40 to 64. Primary insured people are eligible to receive long-term care with 70 to 90 percent of costs covered by the insurance, depending on their income status. Secondary insured people can also access benefits when they suffer from disabilities caused by age-related illnesses such as cerebrovascular diseases.
Of the total primary insured people in the country, 19 percent required nursing care or support in recent years. To compensate for the growing number of people requiring care, the LTCI fees for both age cohorts have steadily risen over the last decade.
Although the number of certified care workers has significantly increased over the past decade, there is a widespread shortage of caregivers. A survey revealed the majority of households with care recipients were nuclear families or one-person households, indicating a high demand for external caregivers. Therefore, the Japanese health ministry has warned about the impacts of this caregiver deficiency in relation to the aging population after 2025.
Long-term care insurance system
Long-term care services and benefits are distributed under the long-term care insurance (LTCI) system established in 2000. Half of the LTCI system’s budget is publicly funded by the central and local governments, while the insurance premium finances the other half. Every Japanese citizen above 40 must join the LTCI and pay these premiums.There are two categories: primary insured people aged 65 years and older and secondary insured people aged 40 to 64. Primary insured people are eligible to receive long-term care with 70 to 90 percent of costs covered by the insurance, depending on their income status. Secondary insured people can also access benefits when they suffer from disabilities caused by age-related illnesses such as cerebrovascular diseases.
Of the total primary insured people in the country, 19 percent required nursing care or support in recent years. To compensate for the growing number of people requiring care, the LTCI fees for both age cohorts have steadily risen over the last decade.
Available services and shortage of caregivers
Long-term care eligibility of primary insured people and the allocation of benefits are determined by the municipalities. There are seven care level categories, from Support Level 1 (needing preventive care for long-term frailty) to Care Level 5 (assigned for bedridden conditions and neurodegenerative ailments). Services are divided into three categories: in-home care, care at nursing facilities, and community-based care. In-home care services are for recipients who live at home and receive services such as domestic help, bathing, and rehabilitation at home or in daycare and short-stay facilities. Nursing institutions offer comprehensive services for in-house residents. Community-based care was established in 2006 to provide flexible services such as monthly flat-rate plans, in which local recipients can receive, for example, home-visit care with a night shift.Although the number of certified care workers has significantly increased over the past decade, there is a widespread shortage of caregivers. A survey revealed the majority of households with care recipients were nuclear families or one-person households, indicating a high demand for external caregivers. Therefore, the Japanese health ministry has warned about the impacts of this caregiver deficiency in relation to the aging population after 2025.
