Venue: The Fuqua School of Business, Duke University, 1 Towerview Drive, Durham, NC 27708-0120

 

Presentation

Barriers to Care among the Elderly in Japan

Authors:

Presenter: Chiyoe Murata (Hamamatsu University School of Medicine)

Discussant: Philip DeCicca (McMaster University)

Session: Lessons from the Japanese National Healthcare Program: Trend, Development, and Future

Room: Classroom C

When: Monday 5:15 p.m. - 6:45 p.m.

In Japan, a set of health care reform is undergoing aiming at cutting the cost and increasing the efficiency of health care. However, expected increase in premium and co-insurance among the elderly might be barriers to necessary care. Studies indicated that increase in out of pocket expenditure reduces the utilization of necessary care especially among low-income individuals. Our study purpose is to investigate the barriers to health care among the elderly in Japan. What kind of barriers exists in Japan? Are such barriers associated with socio-economic status among them?

To answer these questions, we used the data from a large-scale community survey conducted 7 municipalities in 2006 just after the start of the health care reform. A total of 30872 elderly responded the survey with a response rate of 62.7%. Study subjects are 25802 elderly with data on sex and aged 65 years and older (54.3% women). During the past year, 11.5% of respondents reported they did not receive the care they needed. Most reported reasons were long waiting hours (30.1%), felt would be unnecessary (29.5%), dislike of doctors (25.8%), cost (25.1%), and distance (10.7%). Low income elderly were more likely to report problems such as cost, while more high income counterparts reported long waiting hours as a reason for not getting the care. Such results indicated that low income elderly were more sensitive to cost, while high income elderly were more concerned with the quality of care they received.

Our results indicated that increase in out of pocket expenditure might pose barriers to care especially among lower income elderly. Policy makers need carefully investigating the factors that might potentially affect the care seeking decision.