Tomata Yasutake, Tsuji Ichiro, Sugiyama Kemmyo, Hashimoto Shuji, Kawado Miyuki, Yamada Hiroya, Seko Rumi, Murakami Yoshitaka, Hayakawa Takehito, Hayashi Masayuki, Kato Masahiro, Noda Tatsuya, Ojima Toshiyuki
Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine.
Nihon Koshu Eisei Zasshi. 2014;61(11):679-85.
An earlier study using the data from the Japanese Long-term Care Insurance (LTCI) system reported a scenario for achieving the target of Health Japan 21 (the second term): future gains in health expectancy from 2011 to 2020 must be larger than gains in expectancy. According to this scenario (the Healthy Life Expectancy Extension Scenario), the proportion of disability (cases≥Care Level 2 in LTCI disability certification) will gradually decrease by 1% per year from 2011. The purpose of this study was to estimate the cost savings in long-term care and medical care if the Healthy Life Expectancy Extension Scenario is achieved.
We used data from Japanese national statistics and a survey conducted in Osaki city, Miyagi. The natural course of disability cases (≥Care Level 2) was estimated under the assumption that the future population composition would be equal to the population projections for Japan and the future proportion of disabilities for each age grade would be equal to that of 2010. Then, the decrease in the number of disabilities based on the Healthy Life Expectancy Extension Scenario was calculated. Finally, the cost savings in long-term care and medical care associated with the assumed decrease in the number of disability cases was calculated.
When the disability cases (≥Care Level 2) were shifted to "no disability certification (not requiring care)," a total estimated cost reduction of 5,291 billion yen was achieved from 2011 to 2020. Furthermore, a total estimated reduction of 2,491 billion yen was achieved for the same period when all disability shifts to "Care Level 1" were accounted for.
As a rough calculation, if the Health Japan 21 (second term) target is achieved, approximately 2,500-5,300 billion yen will be saved in the cost of long-term care and medical care.
一项早期研究利用日本长期护理保险(LTCI)系统的数据报告了实现“健康日本21”(第二期)目标的一种设想:2011年至2020年健康预期寿命的未来增长必须大于预期寿命的增长。根据这种设想(健康预期寿命延长设想),残疾比例(LTCI残疾认证中护理等级≥2级的病例)将从2011年起每年逐渐下降1%。本研究的目的是估计如果实现健康预期寿命延长设想,长期护理和医疗方面的成本节省情况。
我们使用了日本国家统计数据以及在宫城县大崎市进行的一项调查的数据。在假设未来人口构成与日本的人口预测相同且各年龄组未来残疾比例与2010年相同的情况下,估计了残疾病例(护理等级≥2级)的自然发展过程。然后,计算基于健康预期寿命延长设想的残疾人数减少情况。最后,计算与假设的残疾病例数减少相关的长期护理和医疗方面的成本节省。
当残疾病例(护理等级≥2级)转变为“无残疾认证(无需护理)”时,2011年至2020年估计总成本降低了5.291万亿日元。此外,当考虑所有残疾转变为“护理等级1级”的情况时,同期估计总共减少了2.491万亿日元。
粗略计算,如果实现“健康日本21”(第二期)目标,长期护理和医疗成本将节省约2500 - 5300万亿日元。