Ageing International

, Volume 40, Issue 3, pp 248–261 | Cite as

“Ageing in Place” Policy in Japan: Association Between the Development of an Integrated Community Care System and the Number of Nursing Home Placements Under the Public Long-Term Care Insurance Program Among Municipal Governments

  • Miharu Nakanishi
  • Sayuri Shimizu
  • Takashi Murai
  • Atsushi Yamaoka


In Japan, an “Integrated Community Care” model has been introduced into the public long-term care insurance (LTCI) system to help persons ageing in place. The aim of the present study was to examine the association between the development of an Integrated Community Care system and the number of nursing home placements under the LTCI program among municipal governments in Japan. Development of the Integrated Community Care system was assessed by a paper questionnaire distributed to each municipality. The annual number of elderly nursing home placements was obtained from published national statistics data over a 10-year period from 2001 to 2010. The sample consisted of 612 municipalities (35.1 % of all municipalities) that responded to the questionnaire. A multilevel linear regression analysis for panel data revealed significantly smaller annual numbers of nursing home placements per 1000 elderly persons among municipalities that had larger number of agencies joining in multiple service networks of the Integrated Community Care system. A significantly greater number of nursing home placements was also observed among municipalities that had a larger elderly population rate, lower annual number of elderly individuals in intermediate care per 1000 elderly persons, and smaller number of elderly individuals in congregate housings per 1000 elderly persons. The national “ageing in place” policy should explore a revised model of the Integrated Community Care system that is applicable for areas with limited resources.


Frail elderly Integrated care Local governments Nursing homes Social policy 



The present study was a part of research project on the Integrated Community Care system in the Institute for Health Economics and Policy.


The study was funded by the Institute for Health Economics and Policy (PJ12301). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of data; or preparation, review, and approval of the manuscript.

Conflict of Interest

Author N, Author S, Author M, and Author Y declare that they have no conflict of interest.

Informed Consent

The study did not collect any personal information. The questionnaire contained an introductory section explaining the purpose of the study, the voluntary nature of participation, and the assurance of anonymity of respondents. Participants were not required to sign consent forms; returning the questionnaire implied consent.

Ethical Treatment of Experimental Subjects (Animal and Human)

The study was approved by the Institute for Health Economics and Policy in Japan. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Miharu Nakanishi
    • 1
  • Sayuri Shimizu
    • 2
  • Takashi Murai
    • 3
  • Atsushi Yamaoka
    • 4
  1. 1.Tokyo Metropolitan Institute of Medical ScienceSetagaya-kuJapan
  2. 2.Institute for Health Economics and PolicyMinato-kuJapan
  3. 3.Mizuho Information & Research InstituteChiyoda-kuJapan
  4. 4.Institute for Health Economics and PolicyMinato-kuJapan

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