Current issues in long-term care policy and research:

Toward the promotion of evidence-based policy

Abstract

In Japan, the number of users of the long-term care system has been rapidly increasing, leading to increasing expenditure on benefits; this situation has become an issue from the perspective of the sustainability of the system. In addition, regional disparities in the long-term care cost per person and support for family caregivers are also a challenge. In responding to these issues, it is necessary to promote policies based on evidence, improve the quality and productivity of long-term care services, and expand various services in the community through public participation.

This study aimed to summarize the current status and issues concerning long-term care policies, and introduce the Comprehensive Service for Preventive Care and Daily Life Support for developing diverse care services provided by local citizens and promoting mutual aid in local communities, with the key concepts of “public participation” and “local resources.” Meanwhile, as a trend toward the promotion of evidence-based policy, we discussed an outcome evaluation of long-term care services and an evaluation of the efforts of local governments to support self-reliance and prevent the deterioration of health of the older adults. We reviewed empirical analyses with data and scientific evaluation on long-term care services or their delivering system from various viewpoints, that is, health services research in long-term care. In short, this work clarified the current issues in long-term care policy and research.

As regional disparities become more apparent in Japanese society, the prospect of maintaining a nationwide uniform service system needs to be examined, and the concept of “equity,” revisited. In addition, long-term care service contents will vary dramatically. It will be necessary to break one-way and fixed relationship between the carer and the cared. Multi-disciplinary coordination that includes residents will become more important. To respond appropriately to these issues, scientific evidence-based practice is indispensable where the views and quality of life of patients and the public must be fully considered.