Abstract
The target number of long-term care hospital beds in health care cost control plans of prefectures largely exceeded the expectation of the Ministry of Health, Labour and Welfare, and the current number of long-term care hospital beds will be mostly maintained until the end of fiscal 2012, the target fiscal year. The result of a survey of the decision processes for the health care cost control plans revealed that one of the reasons for this is an effect of the expansion of the local governments' discretion with the progress of decentralization.
Concretely, although the Ministry of Health, Labour and Welfare strictly directed local governments to follow the reference standard, 5 out of the 6 surveyed prefectures used calculation methods of long-term care hospital beds number that were different from the calculation formula of the reference standard and of these, 4 prefectures had numbers that greatly exceeded the target calculated by the government.
This result indicates that the long-term care hospital beds control policy of the government actually “changed”; that is “changed” from the “target numbers assigned by the government” using a uniform calculation method according to therapeutic divisions, to the establishment of “independent and diverse target numbers” based on the actual conditions of local areas.
