scholarly journals Mass evacuation and increases in long-term care benefits: lessons from the Fukushima nuclear disaster

2019 ◽  
Author(s):  
Tomohiro Morita ◽  
Michihito Ando ◽  
Yui Ohtsu
Keyword(s):  
Long Term Care ◽  
Elderly Individual ◽  
Term Care ◽  
Care Level ◽  
Nuclear Disaster ◽  
Care Services ◽  
Fukushima Nuclear Disaster ◽  
Mass Evacuation ◽  
The Impact

AbstractBackgroundThough mass evacuation may increase the need for long-term care (LTC) services, how the need for LTC services increases and how the public LTC system affects it is not well understood. We evaluated changes in public LTC benefits for the people living in the mandatory evacuation areas established after the 2011 Fukushima nuclear disaster and examined the roles of the universal LTC insurance system in Japan.MethodsIn order to evaluate the effect of the mandatory evacuation on LTC benefits, we examined the trends of LTC benefits in the Fukushima evacuation group and the nationwide non-evacuation group. We first decomposed per-elderly-individual benefits at the municipality level into the LTC certification rate and per-certified-individual benefits, and then implemented difference-in-differences analysis using these variables as outcomes.ResultsPer-elderly-individual benefits significantly increased from 2012 onward in the evacuation group, and this was explained by an increase in the certification rate rather than in per-certified-individual benefits. Increases in per-elderly-individual benefits and the certification rate in the post-disaster period were observed in all but the highest care level, and the corresponding outcomes for the highest care level decreased immediately after the disaster. We also found that the increase in the certification rate had been mostly realized by an increase in the number of certified individuals.ConclusionsThe increase in LTC benefits can be associated with the impact of the increase in the number of people newly certified to receive LTC benefits after the mandatory evacuation. In order to cope with the increase in utilization of long-term care and associated costs after disasters in aging societies, both formal long-term care services and social support for informal care for evacuees should be considered important.

scholarly journals Mass evacuation and increases in long-term care benefits: Lessons from the Fukushima nuclear disaster

PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0218835
Author(s):  
Tomohiro Morita ◽  
Michihito Ando ◽  
Yui Ohtsu
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Nuclear Disaster ◽  
Fukushima Nuclear Disaster ◽  
Mass Evacuation

scholarly journals Variation of Care Time Between Nursing Units in Classification-Based Nurse-to-Resident Ratios: A Multilevel Analysis

2018 ◽  
Vol 55 ◽  
pp. 004695801875524
Author(s):  
Albert Brühl ◽  
Katarina Planer ◽  
Anja Hagel
Keyword(s):  
Long Term Care ◽  
Multilevel Models ◽  
Nursing Time ◽  
Term Care ◽  
Care Level ◽  
Levels Of Care ◽  
Indirect Care ◽  
Long Term Care Insurance ◽  
The Impact

A validity test was conducted to determine how care level–based nurse-to-resident ratios compare with actual daily care times per resident in Germany. Stability across different long-term care facilities was tested. Care level–based nurse-to-resident ratios were compared with the standard minimum nurse-to-resident ratios. Levels of care are determined by classification authorities in long-term care insurance programs and are used to distribute resources. Care levels are a powerful tool for classifying authorities in long-term care insurance. We used observer-based measurement of assignable direct and indirect care time in 68 nursing units for 2028 residents across 2 working days. Organizational data were collected at the end of the quarter in which the observation was made. Data were collected from January to March, 2012. We used a null multilevel model with random intercepts and multilevel models with fixed and random slopes to analyze data at both the organization and resident levels. A total of 14% of the variance in total care time per day was explained by membership in nursing units. The impact of care levels on care time differed significantly between nursing units. Forty percent of residents at the lowest care level received less than the standard minimum registered nursing time per day. For facilities that have been significantly disadvantaged in the current staffing system, a higher minimum standard will function more effectively than a complex classification system without scientific controls.

scholarly journals Policies of Personalisation in Norway and England: On the Impact of Political Context

2014 ◽  
Vol 43 (3) ◽  
pp. 479-496 ◽  
Author(s):  
KAREN CHRISTENSEN ◽  
DORIA PILLING
Keyword(s):  
Care Provider ◽  
Long Term Care ◽  
Welfare States ◽  
Ageing Population ◽  
Disabled People ◽  
Term Care ◽  
Care Services ◽  
And Control ◽  
The Impact

AbstractWithin Europe, the Norwegian and English welfare states represent two different welfare regimes. Due to common demographic challenges of an ageing population as well as grass- roots pressures, particularly from disabled people, significant changes in the delivery of long-term care services for older and disabled people have taken place. This article focuses on the change towards personalisation policies encouraging greater choice and control in regard to care services, and uses the case of ‘cash-for-care’, which gives people an allocation of funding to meet their needs, to discuss conditions and implications of personalisation policies within different contexts. Based on a theoretical framework exploring a democratic and a market discourse of personalisation policies, the article provides a comparative analysis of the Norwegian and English cash-for-care schemes. While a crucial common change in the public sector's role towards at-arm’s-length long-term care services occurred, significant differences remain: while English residents are given greater choice and control from the beginning of the allocation of cash-for-care they also face more insecure circumstances due to the simultaneously stimulated care provider market. The Norwegian case, however, shows a possibility of increasing choice and control without a large diversity in a care provider market.

The increase in long-term care public expenditure following the 2011 Fukushima nuclear disaster

2016 ◽  
Vol 70 (7) ◽  
pp. 738-738 ◽  
Author(s):  
Tomohiro Morita ◽  
Claire Leppold ◽  
Masaharu Tsubokura ◽  
Tsuyoshi Nemoto ◽  
Yukio Kanazawa
Keyword(s):  
Public Expenditure ◽  
Long Term Care ◽  
Term Care ◽  
Nuclear Disaster ◽  
Fukushima Nuclear Disaster

Modelling ageing populations to 2030: financing long-term care in England

2018 ◽  
Author(s):  
Michael Murphy ◽  
Ruth Hancock ◽  
Raphael Wittenberg ◽  
Bo Hu ◽  
Marcello Morciano ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Public And Private ◽  
Care Services ◽  
Private Expenditure ◽  
The Impact ◽  
Care Costs

This chapter presents some findings from the research project ‘Modelling Needs and Resources of Older People to 2030’ (MAP2030). The project developed a set of projection models to estimate future family circumstances, incomes, pensions, savings, disability and care needs of older people in England. These projections included public and private expenditure on pensions, disability benefits and care services under different scenarios for reform of pensions and long-term care funding under a range of alternative population futures. The chapter focuses on the projected future costs and impacts for the different income quintiles of the older population of proposed reforms to the system of funding adult social care, in particular the impact of a cap on individual liability to meet care costs.

Long-term care in Spain: a reform failure or the regulation of a development path?

2020 ◽  
Vol 40 (11/12) ◽  
pp. 1301-1317
Author(s):  
Manuel Aguilar-Hendrickson
Keyword(s):  
Long Term Care ◽  
Social Care ◽  
Baby Boom ◽  
Reform Process ◽  
Governance Arrangement ◽  
Term Care ◽  
Content Type ◽  
Care Services ◽  
The Impact

PurposeSpain departed from the Southern European tradition of residual long-term care services with the 2006 reform. The paper aims to present the main traits of the reform and its implementation, explores the reasons that may explain why the reform happened and to which extent and why it fell short of expectations.Design/methodology/approachThe article draws on available literature on the reform and on administrative data to present a complex and nuanced view of the reform process and its limits.FindingsThe reform was actually a measure to enhance and rationalize a preexisting process of social care services development, rather than the creation of a completely new care system. A rapid increase in female labor market participation since the 1990s and the looming demands of a late baby-boom and the subsequent fertility crash appear to be two key factors that explain both the previous development and its bolstering by the reform. The budgetary constraints of the Great Recession and governance problems, linked to a complex and sometimes dysfunctional multilevel governance arrangement, help to understand why the reform bogged down. Nevertheless, the overall balance is more nuanced, and significantly more services are provided 12 years after the reform.Originality/valueWhile many assessments of the reform have been negative, putting it into a larger context of social care development, the 2006 Dependency Act has contributed to a significant increase in expenditure and coverage. The impact of budgetary restrictions has been important, but other factors, such as governance arrangements, may explain more of the problems of the implementation.

Exploring the Impact of the Japanese Long-Term Care Insurance Act on the Gendered Stratification of the Care Labour Market Through an Analysis of the Domiciliary Care Provided by Welfare Non-Profit Organisations

2011 ◽  
Vol 10 (4) ◽  
pp. 433-443 ◽  
Author(s):  
Junko Yamashita
Keyword(s):  
Long Term Care ◽  
Process Of Care ◽  
Term Care ◽  
Unequal Distribution ◽  
Non Profit ◽  
Care Services ◽  
Restructuring Process ◽  
Long Term Care Insurance ◽  
The Impact

Japan's implementation of the Long Term Care Insurance Act in 2000 provides a good example with which to examine the restructuring process of care services for older people, as these have come to be commodified by the welfare state. By focusing on Welfare Non-Profit Organisations provision, this article explores the significance of gender in the restructuring process. It reveals that care services are stratified with institutional care placed at the top of hierarchy of care services costs, and domestic task services at the bottom. There is an unequal distribution of gender and organisational type for each type of care work.

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