Decentralization of welfare policy for the elderly in recent Japan made local municipalities have responsibility to provide services. This means, however, the varieties in the quantity and the quality of services between municipalities. It is difficult to obtain the land for institutions especially in urban municipalities because of the high price of land. Therefore, the shortage of provision is serious problem in urban administration. Furthermore, the demand for services can not be satisfied in own municipality and affects neighborhood municipalities.
From these problems, the present paper aims to clarify how the institutional care services were provided and the needs for services were satisfied in and out of one municipality. Nagoya City, the study area, is one of the major metropolitan city in Japan, with over two million population and it is divided into 16 wards. The object of this study is nursing home for the elderly, which is the most major service in institutional care in Japan.
The results of the study can be summarized as follows:
1) The locations of nursing homes are remarkable in peripheral than central wards of the city relatively. The capacity of beds by wards is not proportional to the population 65 and above.
2) Each nursing homes bases on a variety of types of the organizations; public, welfare facilities, hospital, religious group, private person and so on. Since 1994, the outer organization of the administration, which had financed half by the administration, had built many homes remarkably. Consequently, the location of homes proceeded also in the central wards, where there were no homes so far. This means that unless positive policy for the provision of homes by the administration is adopted it is not easy to increase homes in urban region, where the availability of land is low.
3) Regarding use of nursing homes, many of migrations to enter homes leave for own or neighbor wards. There are more immigrations from other wards where the degree of congestion of homes (the number of beds per 100 people aged 65 years and over) is relatively loose.
4) Correlation coefficient between the provision of nursing homes (the number of persons entered in homes) and the demand (the number of entered and waiting lists) was not significantly different from zero at the 0.05 level. Therefore, the level of territorial justice on nursing homes in Nagoya City is not high.
5) As a result of the principal component analysis on the migrations to enter homes in Nagoya City, six components (cumulative percentage of the total variance; 73.3%) were extracted. By the interpretation of the components, major patterns of immigrants were to“northeast wards”, “southwest wards”and“eastern wards”.
6) Although immigrations to other municipalities leave for the whole of Aichi Prefecture, municipalities in western region of the prefecture had accepted many people from Nagoya City. Immigrations to the municipalities in the next region, policy for provision of services for the elderly, of Nagoya City is surpassing from the peripheral ward which locates on a line from the central of Nagoya City toward to a municipality of destination.
7) Although by municipalities in the prefecture the degree of congestion of homes doesn't have relations with the number of persons from Nagoya City, by the policy district it was obviously proportional to ones. Consequently, most of eleven cities with populated above 100 thousand people had so congested that immigrations from Nagoya City were not so many, except for Toyohashi and Toyokawa where the degree of congestion of homes were loose.
8) Finally, horizontal intergovernmental relations between Nagoya City and its next municipalities were evaluated through the comparison the number of immigrations from Nagoya City and each of their own demand for homes.
抄録全体を表示