A Case Study Report into 24-hour Routine Home Visit Practices as a Form of Person-centered Integrated Care in Japan

By: Hiromi Watanabe  

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.

Social care, Home care, Integrated care, Japan
Public Policy and Public Perspectives on Aging
Paper Presentation in a Themed Session

Hiromi Watanabe

Professor, Human Life Design, Toyo University, Japan

I am professor of Faculty of Human Life Design at Toyo University in Japan.I has 25 years teaching experience, holds a Doctoral Degree of Social Welfare, registered nurse and certified care worker. As professor, my specialized field is elderly care and I run a four-year long care work diploma program which prepares students to become care workers certified by Japanese government. My main research interests involve exploring 24-hour home care. As visiting professor at VIA University of College in Denmark during six months in 2013. I carried out research into the Danish home care system. In 2016 and 2018 I also joined the International Summer School on Integrated Care in the UK. I was a local committee member at the Aging & Society 2018: Eight Interdiciplinary Conference in Japan.