Uneven Nursing Care Service Opportunity and the Behavior of Service Providers under the Long-term Care Insurance System

Miyazawa, Hitoshi

doi:10.4157/grj.76.59

Cited by 19 publications

(7 citation statements)

References 2 publications

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“…Figure 1 illustrates that clinics were often concentrated in parts of each municipality where the population was dense. This trend supports reports on long-term care facility allocation stating that long-term care service providers are concentrated in urban areas due to greater market opportunities [9]. The clinics examined in this study may be distributed similarly to long-term care service providers, as both treat a similar population of disabled community-dwelling people.…”

Section: Clinic Volume and Accessibilitysupporting

confidence: 87%

Association between Geographic Accessibility of Home Care Clinics and Hospitalization in Japan Using Geographic Information Systems and Insurance Claim Data

Naruse¹,

Matsumoto²,

Yamamoto³

et al. 2016

Health

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Measuring and improving home care clinic resource volume and geographic allocation are an important public health issue regarding prolonging home care system usage among disabled elderly people. This study examined clinic volume and accessibility's association with hospitalization duration among disabled elderly people in 13 municipalities in Japan; additionally, this study compared clinic volume and accessibility's ability to explain hospitalization duration in this population. Home care clinics' service volume and geographic accessibility were calculated for 17 municipalities using public data and geographic information systems. We analyzed medical claim data from October 2012; the sample included 22,662 persons who were aged ≥75 years, certified as disabled in daily living, and lived in 13 municipalities regarding which data could be obtained for all examined municipality characteristics. Multilevel logistic models with random intercepts were constructed for municipalities and individual-and municipality-level independent variables in order to examine home care clinic volume and accessibility's correlation with hospitalization duration. Clinic volume ranged from 0 to 9.53 per 10,000 elderly people; clinic accessibility ranged from 0% to 83%. Clinic volume and accessibility were both significantly negatively correlated with hospitalization duration of ≥10 days (odds ratios, 0.944 and 0.713; confidence intervals, 0.914-0.974 and 0.553-0.921, respectively). Clinics were not homogeneously geographically distributed; clinic accessibility explained hospitalization duration better than clinic volume. Clinic accessibility may more accurately indicate care clinic allocation appropriateness than clinic volume.

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Section: Clinic Volume and Accessibilitysupporting

confidence: 87%

Association between Geographic Accessibility of Home Care Clinics and Hospitalization in Japan Using Geographic Information Systems and Insurance Claim Data

Naruse¹,

Matsumoto²,

Yamamoto³

et al. 2016

Health

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“…The regional inequality of in-home care services is explainable by the behavioral characteristics of care service providers that began a welfare business in response to the recent deregulation. Miyazawa (2003) analyzed the relationships between the amount of in-home care services provided and the increase of care service providers in the Kanto Region after the establishment of Long-term Care Insurance. Results indicated that the uneven distribution of in-home care services had been caused by the concentration of commercial companies in home-visit nursing businesses in urban areas.…”

Section: Elderly Care Servicesmentioning

confidence: 99%

“…Rural areas that are less profitable receive fewer commercial companies, and public bodies such as local governments and councils of social welfare play the primary role in providing care services (Miyazawa 2003). Sugiura (2003) reported the conditions of providing services in such areas.…”

Section: Elderly Care Servicesmentioning

confidence: 99%

Geographical Studies of Welfare Issues in Japan since the 1990s

Miyazawa

2013

Geog. Rev. Japan B

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Fertility decline and population aging are progressing rapidly in Japan. To develop an appropriate welfare system to accommodate this aging society, coupled with low fertility, welfare reform has been implemented in Japan since around 2000. Demographic and political changes have stimulated Japanese geographers to study welfare-related issues. Since the latter half of the 1990s, many reports in the literature of Japanese geographical circles have described welfare issues. This article is intended to introduce geographical studies that have specifically examined welfare issues in Japan. There are three themes of the studies: 1) provision of welfare services, especially elderly care services and childcare services; 2) community reorganization to cope with an aging society; and 3) housing problems of vulnerable groups, including single elderly people, female-headed households, and homeless people. This article presents a review of existing geographical studies of each theme, and presents some themes for additional study.

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“…Sugiura (1997Sugiura ( , 2000 has published results on special nursing homes for the elderly and elderly care services, and Miyazawa (2004) has published results on facilities and problems for people with physical handicaps. Both researchers have taken up the problem of care insurance (Miyazawa 2003;Sugiura 2004) . Kamiya (2002) has looked at the problem of psychiatric clinics and analyzed the phenomenon that their locations are concentrated in large cities.…”

Section: Recent Trends In Urban Geographymentioning

confidence: 99%

The Changing Urban Geography of Japan

Abe

2008

Geogr. Rev. JPN, Chirigaku Hyoron

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Abstract:The aim of this article is to examine recent research trends in urban geography in Japan. For this purpose, papers from five major academic journals on geography were reviewed . It has been found that the number of articles on urban geography increased consistently in Japan after World War II, reaching a peak in the 1980s. Although the number decreased somewhat in the 1990s, it is again increasing in the 21st century. Trends in these articles may be summarized as follows: 1) a decrease in studies that examine cities as a single point; 2) an increase in studies that examine cities as an area ; 3) an increase in studies that analyze urban functions; 4) a decrease in studies that use quantitative techniques; 5) an increase in studies that focus on humans themselves; and 6) an increase in studies that deviate from traditional categories . Another important point is that there have come to be a greater number of studies that examine some aspect "in cities" than studies "of cities." A change in the writing style of research reports is also seen. Human agency continues to be a problem taken up in studies of urban geography . In the past, few papers quoted from people directly, whereas today this way of writing is not uncommon. In addition, nowadays there are also articles that directly quote individual opinions and judgments. From the above, recent urban geography may be summarized as having an increasing number of studies that view cities as areas, which serve as the field for examinations of urban functions, people's lives, or social groups, and that emphasize direct voices and narration. The influences of humanistic geography can be seen in the background. However, with excessive focus on urban functions or humans themselves, we run the risk of "not being able to see the forest for the trees." It should also be pointed out that a writing style which relies too much on direct quotes or narration risks the identity of urban geography.

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Uneven Nursing Care Service Opportunity and the Behavior of Service Providers under the Long-term Care Insurance System

Cited by 19 publications

References 2 publications

Association between Geographic Accessibility of Home Care Clinics and Hospitalization in Japan Using Geographic Information Systems and Insurance Claim Data

Association between Geographic Accessibility of Home Care Clinics and Hospitalization in Japan Using Geographic Information Systems and Insurance Claim Data

Geographical Studies of Welfare Issues in Japan since the 1990s

The Changing Urban Geography of Japan

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