2010 Volume 4 Issue 2 Pages 69-85
This article aims to analyze the locational patterns of pay nursing homes supplied by private-sector providers at the national and intra-urban scales. Since the enforcement of the Long-Term Care Insurance in 2000, pay nursing homes have been supplied extensively in metropolitan areas, with the Tokyo metropolitan area in particular accounting for 40 percent of the national capacity. Most pay nursing homes in the Tokyo metropolitan area are located in built-up areas and there are large regional disparities in supplied capacity and nursing home residence costs. Regional capacities are uncorrelated with the welfare and housing needs of the elderly; on the contrary, nursing home residence costs are often more expensive in areas with massive unfulfilled needs. The large number of idle facilities such as closed dormitories for employees of major companies that have been converted to pay nursing homes also have an influence on the regional supply of pay nursing homes. These results indicate a number of issues, namely (1) the expansion of the supply of pay nursing home cannot be dictated by welfare programs since this supply tends to be influenced by economic performance factors such as real estate market; (2) although pay nursing homes play the role of a safety net for elderly persons accidentally left stranded with nowhere to live, regional disparities in nursing home residence costs are a huge risk in terms of strengthening the socio-spatial marginalization of the destitute elderly.