Delivering appropriate care for the aged

• Abstract
• Purpose of health policy or idea
• Characteristics of this policy
• Political and economic background
• Purpose and process analysis
• Expected outcome
• References

Abstract

On July 2006, the Health Care Reform Acts passed the Parliament, which were to establish a new scheme for fundng health care for the aged. A consultation paper on delivering appropriate health care for the aged has been under discussion to develop a modified payment system.

Purpose of health policy or idea

By the Health Care Act in 2006, following the framework set by the Cabinet in 2003, the existing scheme for funding health care will be replaced by the new one from 2008.

A modified payment system is to be used under the new scheme. The paper under discussion set life, dignity, and safety of the aged as principles as well as  insisted comprehensive assessment , home care, palliative care, and integrated care will be critical.

 

Main points

Main objectives

By the Health Care Act in 2006, following the framework set by the Cabinet in 2003, the existing scheme for funding health care will be replaced by the new one from 2008.

A modified payment system is to be used under the new scheme. The paper under discussion set life, dignity, and safety of the aged as principles as well as  insisted comprehensive assessment , home care, palliative care, and integrated care will be critical.      

Type of incentives

Financiand and non-financial incentives will be likely to be introduced.

Groups affected

Providers, Aged persons and their care-givers, Health and social care professional

Innovationsgrad	traditionell		innovativ
Kontroversität	unumstritten		kontrovers
Strukturelle Wirkung	marginal		fundamental
Medienpräsenz	sehr gering		sehr hoch
Übertragbarkeit	sehr systemabhängig		systemneutral

The development of this policy is still underway. The fact that it explicity describe the principles for delivering health care for the aged will be very important, though the principle are controvertial.

The principles are important in the sense that health care resources should be allocated according to them. However, it seems quite difficult to make a payment system accorindg to this policy, which is yet to be done.

Political and economic background

Political pressure to contain health care costs have been quite strong, whereas  the number of population aged 75 and over will be rapidly increase. Together with the economic restrictions, controvertial ethical issues also are emerging issues to be addressed .

 

Purpose and process analysis

Current Process Stages

	Idee	Pilotprojekt	Strategiepapier	Gesetzgebung	Umsetzung	Evaluation	Veränderung/Richtungswechsel
Implemented in this survey?

Origins of health policy idea

Since the 1980s the principles concerned with health care for the aged have been continuously debated. It is a new policy that neigher health professionals nor bioethist  but the Government establish principles of health care for the aged. However, this policy documents are based on discoursed on health care and aging in the last two decades.

Approach of idea

The approach of the idea is described as:
renewed: In other countries, this type of principles have been established byt governments.

Stakeholder positions

Health professions stated their afraid as well as necessity of better service delivery. For example, Japan Medical Association are afraid that the new scheme would increse inequalities in utilization of services. Japan Nursing Association insisted that visiting nursing care shall be more developed to achive the goals that the paper indicated. Since paper are written abstractly, the debate on the matter seems constructive. On the other hand, insures  have tried to set agenda for introducing a patient registration system to a family doctor, which is quite controvertial.

Influences in policy making and legislation

The development of a new payment system has been determined  by the Health Care Reform Act 2006. The current process is an implementation of the act. The policy seemse more explicitly concerned with controvertial issues such as dignity , home care, palliative care.

Adoption and implementation

Academic health professionals, health economists, and consumers have been  involved in developing the consultation paper. Isurers and association of health professions had opportunities to express their opinions. The Governement officials have been likely to keep some distance from the development.

Monitoring and evaluation

The poliy sets a broad view on delivering health care for the aged. Thus this view will be reviewed when detailed policies will be evaluated, though the timing is not stated.

Expected outcome

 This policy set what quality is important for health care for the aged, who means peopel 75 and over. In-depth analysis on the issues will be crtically important for overall policy making in the field of health care.

However, a problem is that it is difficult to distinct those 75 and over from those less than 75 in terms of health care need. In this sense, according to the principles and considerations on health care for the aged, a payment system should be very carefully constructed. 

 

Impact of this policy

Qualität	kaum Einfluss		starker Einfluss
Gerechtigkeit	System weniger gerecht		System gerechter
Kosteneffizienz	sehr gering		sehr hoch

In the sense that this policy set the principles of delivering health care for the aged, it's impact can be fundamenta. Impact on equity and efficiency will depend on a payment system that will be developed on this policy.

References

Sources of Information

Special Committee on Health Care for the Aged, Social Security Council(2007) Health Care for the aged 75 and over: principles and challenges.

Author/s and/or contributors to this survey

Ryozo Matsuda

Empfohlene Zitierweise für diesen Online-Artikel:

Ryozo Matsuda. "Delivering appropriate care for the aged". Health Policy Monitor, March 2007. Available at http://www.hpm.org/survey/jp/a9/2