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Open Access
Article
Publication date: 19 July 2021

Koki Hirata, Kunichika Matsumoto, Ryo Onishi and Tomonori Hasegawa

The purpose of this article is to clarify the social burden of Japan’s three major diseases including Long-term Care (LTC) burden.

2507

Abstract

Purpose

The purpose of this article is to clarify the social burden of Japan’s three major diseases including Long-term Care (LTC) burden.

Design/methodology/approach

A modification of the Cost of Illness (COI)—the Comprehensive-COI (C-COI) was utilized to estimate three major diseases: cancer, heart disease, and cerebrovascular diseases (CVD). The C-COI consists of five parts: medical direct cost, morbidity cost, mortality cost, formal LTC cost and informal LTC cost. The latter was calculated by two approaches: opportunity cost approach (OC) and replacement approach (RA), which assumed that informal caregivers were substituted by paid caregivers.

Findings

The C-COI of cancer, heart disease and CVD in 2017 amounted to 10.5 trillion JPY, 5.2 trillion JPY, and 6.7 trillion JPY, respectively (110 JPY= 1 US$). The mortality cost was preponderant for cancer (61 percent) and heart disease (47.9 percent); while the informal LTC cost was preponderant for CVD (27.5 percent). The informal LTC cost of the CVD in OC amounted to 1.8 trillion JPY; while the RA amounted to 3.0 trillion JPY.

Social implications

The LTC burden accounted for a significant proportion of the social burden of chronic diseases. The informal care was maintained by unsustainable structures such as the elderly providing care for the elderly. This result can affect health policy decisions.

Originality/value

The C-COI is more appropriate for estimating the social burden of chronic diseases including the LTC burden and can be calculated using governmental statistics.

Details

Public Administration and Policy, vol. 24 no. 2
Type: Research Article
ISSN: 1727-2645

Keywords

Open Access
Article
Publication date: 10 August 2020

David Bogataj, Valerija Rogelj, Marija Bogataj and Eneja Drobež

The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent…

1459

Abstract

Purpose

The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent on the help of others is a crucial question in the European Union (EU). The housing stock in Europe is not fit to support a shift from institutional care to the home-based independent living. Some 90% of houses in the UK and 70%–80% in Germany are not adequately built, as they contain accessibility barriers for people with emerging functional impairments. The available reverse mortgage contracts do not allow for relocation to their own adapted facilities. How to finance the adaptation from housing equity is discussed.

Design/methodology/approach

The authors have extended the existing loan reverse mortgage model. Actuarial methods based on the equivalence of the actuarial present values and the multiple decrement approach are used to evaluate premiums for flexible longevity and lifetime long-term care (LTC) insurance for financing adequate facilities.

Findings

The adequate, age-friendly housing provision that is appropriate to support the independence and autonomy of seniors with declining functional capacities can lower the cost of health care and improve the well-being of older adults. For financing the development of this kind of facilities for seniors, the authors developed the reverse mortgage scheme with embedded longevity and LTC insurance as a possible financial instrument for better LTC services and housing with care in assisted-living facilities. This kind of facilities should be available for the rapid growth of older cohorts.

Research limitations/implications

The numerical example is based on rather crude numbers, because of lack of data, as the developed reverse mortgage product with LTC insurance is a novelty. Intensity of care and probabilities of care in certain category of care will change after the introduction of this product.

Practical implications

The model results indicate that it is possible to successfully tie an insurance product to the insured and not to the object.

Social implications

The introduction of this insurance option will allow many older adult with low pension benefits and a substantial home equity to safely opt for a reverse mortgage and benefit from better social care.

Originality/value

While currently available reverse mortgage contracts lapse when the homeowner moves to assisted-living facilities in any EU Member State, in the paper a new method is developed where multiple adjustments of housing to the functional capacities with relocation is possible, under the same insurance and reverse mortgage contract. The case of Slovenia is presented as a numerical example. These insurance products, as a novelty, are portable, so the homeowner can move in own specialised housing unit in assisted-living facilities and keep the existing reverse mortgage contract with no additional costs, which is not possible in the current insurance products. With some small modifications, the method is useful for any EU Member State.

Details

Facilities, vol. 38 no. 9/10
Type: Research Article
ISSN: 0263-2772

Keywords

Open Access
Article
Publication date: 19 September 2022

Tyler Aird, Ceara Holditch, Sarah Culgin, Margareta Vanderheyden, Greg Rutledge, Carlo Encinareal, Dan Perri, Fraser Edward and Hugh Boyd

The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute…

1381

Abstract

Purpose

The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute care hospital information system (HIS) and a long-term care (LTC) home electronic medical record through a case report.

Design/methodology/approach

Utilization statistics of the data integration solution were captured at one-month post implementation and again one year later for both the emergency department (ED) and LTC home. Clinician feedback from surveys and structured interviews was obtained from ED physicians and a multidisciplinary LTC group.

Findings

The authors successfully exchanged health information between a HIS and the electronic medical record (EMR) of an LTC facility in Canada. Perceived time savings were acknowledged by ED physicians, and actual time savings as high as 45 min were reported by LTC staff when completing medication reconciliation. Barriers to adoption included awareness, training efficacy and delivery models, workflow integration within existing practice and the limited number of facilities participating in the pilot. Future direction includes broader staff involvement, expanding the number of sites and re-evaluating impacts.

Practical implications

A data integration solution to exchange clinical information can make patient transfers more efficient, reduce data transcription errors, and improve the visibility of essential patient information across the continuum of care.

Originality/value

Although there has been a large effort to integrate health data across care levels in the United States and internationally, the groundwork for such integrations between interoperable systems has only just begun in Canada. The implementation of the integration between an enterprise LTC electronic medical record system and an HIS described herein is the first of its kind in Canada. Benefits and lessons learnt from this pilot will be useful for further hospital-to-LTC home interoperability work.

Details

Journal of Integrated Care, vol. 30 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 30 March 2022

Phudit Tejativaddhana, Nalinee Nakittipha Chuakhamfoo and Man Thi Hue Vo

This paper aims to explore the aging society situation, long-term care (LTC) policy preparation, COVID-19’s impact on older people, and post-pandemic preparations in Thailand and…

1628

Abstract

Purpose

This paper aims to explore the aging society situation, long-term care (LTC) policy preparation, COVID-19’s impact on older people, and post-pandemic preparations in Thailand and the implications for The Association of Southeast Asian Nations (ASEAN) countries.

Design/methodology/approach

Online databases from international, national, academic agencies and SCOPUS database from January 2019 to July 2021 were utilized for analysis. Relevant literature and data were selected for review.

Findings

The evidence suggests that the proportion of the aging population is increasing due to declined fertility and rising life expectancy. Current and future demand for effective healthcare in ASEAN will be better achieved with policies like the Universal Health Coverage and Primary Health Care system. While some countries, specifically Thailand, are developing and expanding their LTC policies, some concerns regarding the active aging policy remain. Most ASEAN countries are using public domain for LTC policies. However, the COVID-19 pandemic has posed a major challenge in implementing LTC and affected the vulnerable aging population in many aspects, including social protection issues in Thailand.

Originality/value

With the support from international organizations, ASEAN countries have framed several policy strategies in response to the increasing aging population, such as providing more LTC in the community. The unexpected challenges from the COVID-19 pandemic compel policymakers to consider resource allocations and community-based services. On the positive side, as the pandemic has made the vulnerable group exposed, social protection issues have been brought to the forefront of the political debate and called for an appropriate policy response.

Details

Public Administration and Policy, vol. 25 no. 1
Type: Research Article
ISSN: 1727-2645

Keywords

Open Access
Article
Publication date: 20 July 2021

Martin Powell

This article explores to what extent the long debate in England over the funding of long-term care (LTC) has involved learning from abroad.

Abstract

Purpose

This article explores to what extent the long debate in England over the funding of long-term care (LTC) has involved learning from abroad.

Design/methodology/approach

It draws on Mossberger and Wolman’s (2003) framework which proposes criteria for assessing policy transfer as a form of prospective policy evaluation: awareness; assessment and application. The documents examined are the sources cited by the reports that examined funding LTC in England since 1999. The study uses interpretive content analysis in a deductive approach (applying the framework) that focuses on both manifest and latent content.

Findings

It finds that both the reports and the cited studies tend to focus on a fairly narrow range of nations, with most attention on Germany, Japan and Scotland. Most studies broadly do not provide much in the way of a clear rationale, and the level of details provided varies. There is relatively little focus on problems. Aims, objectives and goals are little mentioned in some studies, but they tend to be fairly abstract or “high level.” Similarly, there is limited detail on settings. Finally, only a few studies provide a clear recommendation.

Originality/value

It focuses on the neglected topic of the evidence behind reports which are intended to provide recommendations for policy change. The Mossberger and Wolman’s (2003) framework has been used in a small-scale but appears to be well-suited for this purpose.

Details

Fulbright Review of Economics and Policy, vol. 1 no. 1
Type: Research Article
ISSN: 2635-0173

Keywords

Open Access
Article
Publication date: 30 January 2004

Sang-yirl Nam

World trade has been increasing rapidly and much faster than world output. This study analyzes the trade structures of major dynamic East Asian countries as well as regional…

Abstract

World trade has been increasing rapidly and much faster than world output. This study analyzes the trade structures of major dynamic East Asian countries as well as regional subgroups such as ASEAN members and Northeast Asian countries. Emphasis will be on the complementarities that would enhance integration among them through international trade. In addition, potential trade levels for each combination of East Asian countries are estimated by applying the gravity model of trade to the trade flows of21 APEC members, as a reference group. It is estimated to have significant potentiality by regional subgroup, ASEAN or Northeast Asia, and not between the two regional subgroups. However, the potential integration between East Asian countries in different regional subgroups is more significant by considering complementarities in trade compared with the results from the basic gravity model. To enhance economic cooperation between East Asian countries, expanding relationships such as inter-industry trade in natural resources trade and industrial goods between the regional subgroups needs to occur. They should also utilize complementary relationships from intra-industry trade in industrial goods such as electric and electronic equipment, related parts and accessories. And they should focus on the implementation of trade facilitation measures based on global standards.

Details

Journal of International Logistics and Trade, vol. 1 no. 2
Type: Research Article
ISSN: 1738-2122

Keywords

Open Access
Article
Publication date: 23 November 2020

Tomonori Hasegawa, Kunichika Matsumoto, Ryo Onishi and Koki Hirata

The purpose of this paper is to examine the health sector reform toward 2040 of Japan as a super-aged society.

2898

Abstract

Purpose

The purpose of this paper is to examine the health sector reform toward 2040 of Japan as a super-aged society.

Design/methodology/approach

This paper discusses the current healthcare policies adopted in Japan and projects the challenges in future as a super-aged society.

Findings

Through Japanese experiences, it is considered that Community-based Integrated Care System is useful, which takes into account the perspective of health care users. Being a super-aged society, it is essential for Japan to have more consensus by further removing obstacles, and paying attention to the change of paradigm and the purpose of care.

Originality/value

Based on the case of Japan, this paper serves as a reference for other East Asian countries, which would sooner or later encounter the similar situation of becoming super-aged societies in the 21st century.

Details

Public Administration and Policy, vol. 23 no. 3
Type: Research Article
ISSN: 1727-2645

Keywords

Open Access
Article
Publication date: 14 October 2022

Gigi Lam

This article analyses community care services (CCS) in terms of availability, awareness, accessibility, and acceptance (the Four A’s approach), untangles the deep-seated factors…

4449

Abstract

Purpose

This article analyses community care services (CCS) in terms of availability, awareness, accessibility, and acceptance (the Four A’s approach), untangles the deep-seated factors underlying the CCS and provides some short-term, medium-term, and long-term recommendations.

Design/methodology/approach

A literature review was conducted, including relevant government reports, consultation papers, Legislative Council papers and articles from academic journals from 1980 to the present.

Findings

The Four A’s approach shows that applicants to both centre-based services and home-based services endure lengthy waiting times because of the limited number of CCS. Furthermore, the awareness of day respite services is approximately 50 percent, which lags behind other CCS. Accessibility is contingent on a cross-district day respite service system and a lack of consistency between the quota and the proportion of older adults in the districts. Finally, the level of service provided by CCS is unsatisfactory due to inflexible service provision. Reviewing the brief history of long-term care services (LTC) reveals the deep-seated factors at the core of their heavy reliance on the subvention model, in contrast to the adoption of the ‘mixed economy of care’ by residential care services (RCS). An imbalance in budget allocation to RCS and CCS is also revealed.

Originality/value

Although the principle of ‘ageing in place’ was introduced in 1977, the institutionalisation rate (6.8 percent) of older adults remains unexpectedly high in Hong Kong, even surpassing its Asian counterparts, whereas the usage rate of CCS hovers around 0.8 percent. Thus, how to implement policy concerning LTC services for older adults must be re-evaluated.

Details

Public Administration and Policy, vol. 25 no. 3
Type: Research Article
ISSN: 1727-2645

Keywords

Open Access
Article
Publication date: 28 June 2022

Olli Väänänen and Timo Hämäläinen

Minimizing the energy consumption in a wireless sensor node is important for lengthening the lifetime of a battery. Radio transmission is the most energy-consuming task in a…

1009

Abstract

Purpose

Minimizing the energy consumption in a wireless sensor node is important for lengthening the lifetime of a battery. Radio transmission is the most energy-consuming task in a wireless sensor node, and by compressing the sensor data in the online mode, it is possible to reduce the number of transmission periods. This study aims to demonstrate that temporal compression methods present an effective method for lengthening the lifetime of a battery-powered wireless sensor node.

Design/methodology/approach

In this study, the energy consumption of LoRa-based sensor node was evaluated and measured. The experiments were conducted with different LoRaWAN data rate parameters, with and without compression algorithms implemented to compress sensor data in the online mode. The effect of temporal compression algorithms on the overall energy consumption was measured.

Findings

Energy consumption was measured with different LoRaWAN spreading factors. The LoRaWAN transmission energy consumption significantly depends on the spreading factor used. The other significant factors affecting the LoRa-based sensor node energy consumption are the measurement interval and sleep mode current consumption. The results show that temporal compression algorithms are an effective method for reducing the energy consumption of a LoRa sensor node by reducing the number of LoRa transmission periods.

Originality/value

This paper presents with a practical case that it is possible to reduce the overall energy consumption of a wireless sensor node by compressing sensor data in online mode with simple temporal compression algorithms.

Details

Sensor Review, vol. 42 no. 5
Type: Research Article
ISSN: 0260-2288

Keywords

Open Access
Article
Publication date: 7 March 2023

Tomonori Hasegawa, Koki Hirata and Kunichika Matsumoto

This article analyzes the challenges of infectious disease control under a super-aged society through Japan’s experience with COVID-19.

Abstract

Purpose

This article analyzes the challenges of infectious disease control under a super-aged society through Japan’s experience with COVID-19.

Design/methodology/approach

This article provides an overview of Japan’s COVID-19 measures and their characteristics, discusses their successes and failures, and identifies future challenges.

Findings

Japan’s basic strategy for COVID-19 consists of three parts: the border defense (Stage 1), slowing down the spread (Stage 2), and damage control (Stage 3). One key policy feature in Stage 2 and Stage 3 is based on “voluntary restriction”. It had a certain effect, but it was prolonged with each recurring “wave of infection”, resulting in economic exhaustion and people’s dissatisfaction. Thus, the effect of the voluntary restriction has weakened, while the percentage of people who have been vaccinated is improving, making it difficult to predict the damage of the next “wave”. Under the hyper-aged society, it was necessary to identify and protect particularly vulnerable areas, i.e., psychiatry hospitals, chronic care hospitals, and long term care (LTC) facilities. On the other hand, secondary impacts extend to young people. The most serious one is the decrease in births which further accelerates the aging of society.

Originality/value

This study is original as it investigated why Japan’s unique countermeasures against COVID-19 without mandatory lockdown worked well for a considerable period. It also revealed that secondary impacts of the COVID-19 epidemic are broader and more significant than the direct loss of life, and that the social system, especially super-aged society with many vulnerable areas should be reformed in consideration of the threat of infectious diseases. Lessons from the Japanese case may contribute to other countries.

Details

Public Administration and Policy, vol. 26 no. 1
Type: Research Article
ISSN: 1727-2645

Keywords

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