The aim of our research in the First Domain, the “Establishment of Elderly Care Policy Science,” is to improve the quality of elderly care, an issue that is expected to become more and more important in future welfare society development. Such improvements should be realized not only at the level of practical and individual cases, but also at the level of care service facilities, service providers, and local and central government. Further, it is indispensable to implement the Plan-Do-Check-Action (PDCA) management cycle within all these levels in order to attain sustainable quality improvements (Figure 1). Specifically, at the level of practical individual cases, improvement in the Quality of Life (QOL) is required all through the care process, from sound health maintenance to terminal care (Figure 2).

To promote Elderly Care Insurance, the self-motivated involvement of local governments and communities is indispensable as they are the actual providers of such insurance. Thus each local government and community must understand how to evaluate the effects of their policies and the usage of their services, and how to resolve any problems identified through such evaluations. The Long-Term Care Insurance Provision Analysis software developed to help governments and communities is now used by 60% of local governments in Japan.
We are currently developing a method to compare the effect of Long-Term Care Insurance and other aspects among local governments, based on data from 146 local governments. The major features of this method are: analyzing the changes between two points of time; use of both existing data, such as the number of Certifications of Eligibility for Long-term Care issued by each government, and data from our additional survey; usage of data from actual individual cases; multi-dimensional evaluations that utilizes seven indexes: (1) regional characteristics, (2) subjects, (3) service availability, (4) service usage, (5) effects, (6) efficiency, and (7) fairness. Our aim in this research is not only analyzing the current situation, but also establishing a Local Government Support System that assists local governments in obtaining such analysis feedback and sharing expertise in planning and developing policies.

This ongoing study, a joint collaboration with Mie Prefecture, aims at developing a method of evaluating institutional care services by a third party. In the initial stage of this study, we have established an evaluation method of care services in Special Nursing Homes for the Elderly. We have extended the scope of the second stage of our studies to include services in Geriatric Health Care Facilities.

This research covers 7,000 elderly persons in care and their caregivers in search of a care management model that assures the quality of life for both the cared-for and the caregivers. Through our research, we found that 20% of those in care are left in a state where neglect and abuse are suspected and also many caregivers are suffering from depression. In the future, we hope to establish a care management plan that prevents further physical deterioration of those in care, by collating the data possessed by insurers (i.e. local governments) such as the Certification of Eligibility for Long-Term Care.