Department of Economics, Ohtsuki City College, Ohtsuki City, Yamanashi 401-0012, Japan.
Int J Environ Res Public Health. 2023 Jan 22;20(3):2027. doi: 10.3390/ijerph20032027.
This study aims to identify the state-family nexus in long-term care (LTC) provision for older adults in Italy and Japan which have been considered to be a familialistic welfare state and the most ageing societies in the world. Based on the more developed theoretical approach of the familialism-defamilialization continuum of care, represented by Saraceno (2016), the public policy systems as well as the LTC provision and the work-LTC reconciliation of family caregivers in particular, were compared between Italy and Japan. While both countries have lower level of institutional care, and particularly high proportions of family caregivers with relatively heavy care burdens, the share of cash-based and home care as well as the age range and family relationship of family caregivers significantly differ. Focusing on the peculiarities of LTC that the state-(market)-family cannot always be clearly separated, this study identified that the size of public expenditure, i.e., the role of the state does not immediately lead to a defamililization of care. This can contribute to the policy making for care provision and work-LTC reconciliation in several countries that will become super-aging societies in the coming decades.
本研究旨在探讨意大利和日本在长期护理（LTC）提供方面的家庭-国家关系。意大利和日本被认为是家庭主义福利国家和世界上人口老龄化最严重的社会。本研究以萨拉切诺（Saraceno，2016）提出的更为发达的护理家庭主义-非家庭主义连续体理论为基础，比较了两国的公共政策体系以及 LTC 服务提供和家庭照顾者的工作-家庭护理协调情况。虽然这两个国家的机构护理水平都较低，家庭照顾者的比例相对较高，且照顾负担较重，但现金和家庭护理的比例、家庭照顾者的年龄范围和家庭关系存在显著差异。本研究关注到 LTC 的特殊性，即国家（市场）-家庭之间并不总是能够明确区分，因此确定公共支出的规模，即国家的作用并不一定会导致护理的非家庭化。这有助于为未来几十年将成为超老龄化社会的几个国家的 LTC 服务提供和工作-家庭护理协调制定政策。
