scholarly journals Transitional and Long-Term Care System in Japan and Current Challenges for Stroke Patient Rehabilitation

2022 ◽  
Vol 12 ◽  
Author(s):  
Shoji Kinoshita ◽  
Masahiro Abo ◽  
Takatsugu Okamoto ◽  
Kohei Miyamura
Keyword(s):  
Medical Care ◽  
Long Term Care ◽  
Service Providers ◽  
Medical Insurance ◽  
Term Care ◽  
Multidisciplinary Rehabilitation ◽  
Rehabilitation Therapy ◽  
Insurance System ◽  
Care System

In Japan, the national medical insurance system and long-term care insurance (LTCI) system cover rehabilitation therapy for patients with acute, convalescent, and chronic stroke. Medical insurance covers early and multidisciplinary rehabilitation therapy during acute phase hospitalizations. Patients requiring assistance in their activities of daily living (ADL) after hospitalization are transferred to kaifukuki (convalescent) rehabilitation wards (KRW), which the medical insurance system has also covered. In these wards, patients can receive intensive and multidisciplinary rehabilitation therapy to improve their ADL and transition to a smooth home discharge. After discharge from these hospitals, elderly patients with stroke can receive outpatient (day-care) rehabilitation and home-based rehabilitation using the LTCI system. The Japanese government has proposed building a community-based integrated care system by 2025 to provide comprehensive medical services, long-term care, preventive care, housing, and livelihood support for patients. This policy aims to promote smooth coordination between medical insurance services and LTCI providers. Accordingly, the medical insurance system allows hospitals to receive additional fees by providing patient information to rehabilitation service providers in the LTCI system. A comprehensive database on acute, convalescent, and chronic phase stroke patients and seamless cooperation between the medical care system and LTCI system is expected to be established in the future. There are only 2,613 board-certified physiatrists in Japan, and many medical schools lack a department for rehabilitation medicine; establishing such a department at each school is encouraged to teach students efficient medical care procedures, to conduct research, and to facilitate the training of personnel in comprehensive stroke rehabilitation.

scholarly journals LONG-TERM CARE IV A REVIEW OF THE LONG-TERM CARE INSURANCE PROGRAMS IN 15 PILOT CITIES IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S801-S801
Author(s):  
Yan Lin ◽  
Edward A Miller ◽  
Marc A Cohen ◽  
Pamela Nadash ◽  
Peng Du
Keyword(s):  
Long Term Care ◽  
Service Providers ◽  
Population Policy ◽  
Medical Insurance ◽  
Implementation Barriers ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Long Term Care Insurance

Abstract China is now making all the efforts to solve the problem of who pays the bill for the rapidly increasing long-term care services. Since 2016, 15 cities in China have begun their pilot programs in long-term care insurance. Each city designed its own program. Some cities finance their long-term care services from medical insurance funding solely. Others supplement it with individual and/or employer contributions. This study documents the nature and extent of implementation of long-term care insurance across the 15 pilot cities to draw lessons for subsequent implementation nationally. This study used qualitative methods, including document review and key informant interviews with long-term care insurance administrators, medical insurance administrators, service providers in different settings and families and individuals who use long-term care services. Results reveal considerable variation in the specific attributes of the long-term care insurance programs implemented across the 15 participating cities, with respect to such characteristics as the target population, policy coverage, and payment methods, etc. Results also shed light on the achievements and challenges in implementing the long-term care insurance program. This study’s examination of long-term care insurance adoption in 15 Chinese cities serves as an important base with which to inform future national long-term care insurance design and implementation. It suggests that successful adoption of long-term care insurance across China will require administering jurisdictions to anticipate and address policy bottlenecks and implementation barriers that might otherwise inhibit program impact and effectiveness in addressing the growing long-term care needs of China’s aging population.

The Dutch Long-Term Care System in Transition: Implications for Municipalities

2015 ◽  
Vol 78 (08/09) ◽  
pp. e53-e61
Author(s):  
W. Jongen ◽  
M. Commers ◽  
J. Schols ◽  
H. Brand
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Care System
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