The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67780

Sachiyo Murashima, PhD, RN, PHN¹, Azusa Yokoyama, BS, RN, PHN¹, Satoko Nagata, MHlthSc, RN, PHN¹, Kiyomi Asahara, PhD, PHN, RN², and Caroline M. White, DrPH, RN³. (1) Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan, 81-3-5841-3695, murasima-tky@umin.ac.jp, (2) School of Health Sciences, Shinshu University, 3-1-1 Asahi, Matsumoto-shi, Nagano, 960-1295, Japan, (3) St. Lukefs College of Nursing, 10-1, Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan

In April 2000 the new Long-Term Care Insurance (LTCI) program was implemented in Japan. This program represents a major policy change and system re-design. As background, we briefly review the factors leading to the development of LTCI and explain the philosophy and mechanism of LTCI. Then we describe patients' access to the system, financial costs, changes in long-term care (LTC) system patterns and their impacts on institutional care and home care.

Although those who need LTC services and their families are most affected by the policy and its implementation, the nursing profession has also experienced new challenges and opportunities to improve its services. At the system level, more nurses are in more visible community roles as care managers and directors of visiting nurse service stations. Systems for discharge planning after hospitalization are being piloted; providing coordinated, timely service delivery at home and quality assurance are issues of on-going concern. And, surveys describe individual practices to help frail elders at home and programs to prevent falls and untoward decline in quality of life and performance of activities of daily living (e'kaigo yobou").

With this presentation we want to share with American public health nurses: 1) how the LTCI has brought remarkable changes in the delivery of LTC in Japan and 2) the ways in which public health nurses are expanding the scope of their practice and focusing their research.

Learning Objectives:

• At the conclusion of the session, the participant in this session will be able to recognize how the Long-Term Care Insurance has brought remarkable changes in the delivery of long-term care in Japan and the ways in which public health nurses are expanding the scope of their practice and focusing their research

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.