Aging & Social Change: Ninth Interdisciplinary Conference

Abstract

The Long-Term Care Insurance Law (LTCI) was established in Japan in 2000 as a form of public care service insurance, managed publicly but designed based on private business models. In 2012, 24-hour routine home visits were introduced through reforms to the LTCI. While this service delivers both fixed-regulation home help and on-call visits, delivery is limited to major cities due to issues with finances, hiring care staff, responding to emergency calls, and providing service at night. In addition, providers of 24-hour routine home visit services are required to offer high quality care catered to individual service users, many of whom have complex care requirements, such as medical conditions, and food, and housekeeping needs. As such, integrated care services must be well coordinated. With the aims of exploring how 24-hour routine home care visits are provided despite running at a financial deficit, and investigating how social care services are coordinated and organized to include self-care, semi-structured interviews were carried out with the managers of four care service providers offering a 24-hour routine home visit service in Tokyo. The results of this case study suggest that, while person-centered integrated care was delivered based on individual patient needs, there is a lack of formalized support structure, which appears to be compensated for by the efforts and professionalism of individual staff.