Does an Increase in the Availability of Formal Long-term Care Affect Hospital Discharge of Elderly Patients in Japan?

Abstract

Moving elderly inpatients needing nursing care from hospitals to long-term care facilities is of great policy concern in Japan. We analyzed whether the introduction of public long-term care insurance in 2000 had any effect on these elderly inpatients. A log-logistic hazards model is used to estimate the conditional probability of hospital discharges for elderly inpatients between 1998 and 2003. Our empirical宣ndingsindicate that increases in the number of beds in long-term care facilities significantly increased the hazard of discharges of these elderly inpatients from hospitals. This effect was accelerated by the revision of medical service fee schedules in 2002 in which hospitals were charged a 15% penalty for inpatients hospitalized for 180 days or more.