An Investigation of Factors Influencing High Usage of Medical and Long-Term Care Services in an Aging Society in Japan

Asia Pac J Public Health. 2018 Mar;30(2):95-106. doi: 10.1177/1010539517751444. Epub 2018 Jan 5.


Medical and long-term care costs are increasing all over the world. In this study, we investigated the characteristics of groups with high cost of medical and long-term care to define targets for curbing social security costs. As a result, for the population covered by the National Health Insurance, a large portion of medical costs were incurred for mental disorders, malignant neoplasms, and lifestyle-related diseases. For those covered by the Late Elderly Health Insurance System, most medical costs were incurred for lifestyle-related diseases, femoral fractures, neurological diseases, mental disorders, pneumonia, malignant neoplasms, and Alzheimer's disease. From multiple regression analysis, the hospitalization days, use of advanced medical treatment, outpatient days, and high long-term care level influenced the increased costs. On the other hand, disease characteristics had only a very low effect. These findings suggest that the target population has complex medical and long-term care needs because they have multiple diseases.

Keywords: aging society; elderly; health care services; health management; long-term care cost; medical cost.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Health Care Costs / statistics & numerical data*
  • Health Services / economics*
  • Humans
  • Japan
  • Long-Term Care / economics
  • Male
  • Middle Aged
  • National Health Programs / economics
  • Risk Factors
  • Social Security / economics