This paper discusses the location and present state of the service and supply of commuting type facilities in service areas that changed after the introduction of the long-term care insurance system. It also analyzes the conditions for determining the facilities selection by the users as formation factors in the service areas, and examines the relationship between the conditions for determining the facilities and the service area of facilities.
Research methods include interview surveys of facilities, and a questionnaire survey for users and their families. The study area was Musashino city which is located in the Tokyo metropolitan area.
The location of commuting for care facilities does not correlate with the distribution of the elderly population. On the other hand, the location of commuting rehabilitation services facilities correlates well with the distribution of the elderly population. Most of the commuting for care facilities are being constructed by the municipality. Extensive sites are necessary for the construction of commuting for care facilities, since they are mainly established as an addition to special nursing homes for the elderly. Therefore, the commuting for care facilities have been located in regions with small populations, and there is no correlation with the distribution of the aged population.
There are two patterns regarding the conditions for determining facilities selection. One is the pattern in which the facilities selection is left to the care manager. In another, the proximity from the homes of users is a primary condition. If multiple facilities are located in a region near to the homes of users, the users choose the facilities by service content and equipment, and on the advice of the care manager.
When care managers make care plans, it is necessary for them to choose the service provider because the care manager belongs to the service provider. The primary condition of choosing a service provider is the proximity from the homes of users to the provider who has the facilities which users can utilize.
Hardware such as baths is an important index when facilities are chosen by service content and equipment. Therefore, the result of pursuing better equipment often leads to the user choosing a facility that is not the closest to their homes.
From the above, the spatial factor assumes considerable importance in the conditions for determining the facilities selection. From this fact, it is necessary to properly organize the facilities which are established as an addition. Furthermore, it is also necessary to execute the plan by taking special care over the service area of commuting type facilities.