日本介護保險實施現況、發展與未來

The Current State, Development and the Future of Long-term Care System in Japan

李光廷(Kuang-Ting Lee)

《研考雙月刊》 32卷6期 (2008/12) Pp. 53-67

https://doi.org/10.6978/YKSYK.200812.0053

摘要

日本介護保險自2000年實施以來，歷經2次保險費提高（2003年、2005年）及1次縮減給付改革（2006年）。導致保險費提高的原因在於：一、人口高齡化的進展，需照護老人比率升高，給付費隨之增加；二、利用服務人數及比率增加，給付費重顯著提高。若不及時改善，保險財務將無法支應。
2006年度大幅度改革以「維持制度永續經營」為方針，以「給付效率化及重點化」為主軸，內容強調：一、削減不必要的給付，提供適當且必要的服務；二、機構照護住宿費全額自付，導正機構與居家兩者間照護費用的公平性。基於此前提，負責控管服務提供適當與公平的照護管理師責任重大。
落實「照護給付適當化」的困難度相當高，介護保險制度改革成效有待後續追蹤檢驗。

關鍵字

介護保險改革 ； 需照護認定 ； 照護管理 ； 照護給付適當化

並列摘要

Since its enforcement in 2000, the long-term care system in Japan has raised its premiums in 2003 and 2005, also reduced its coverage in 2006. The driving forces behind raising premiums are (1) The aging of society, which increases the proportion of senior citizens needing the long-term care, and (2) An increase in the population that utilizes the long-term care system.
Long term care insurance reforms in 2006 are based on sustainability and efficient coverage, with emphases on (1) Reduction of excessive coverage and (2) Residence expense self-load in nursing home for fairness of care costs between residential care and home care. As this premise, the care managers who provide and manage long-term care services become even more important.
Enforcing proper long-term coverage has its difficulties; the actual results of these regulations still remain to be seen.

並列關鍵字

long term care insurance reform ； care need assessment ； care management ； regulation of nursing-care benefits