Association of the 2018 Japanese Financial Incentive Policy With Long-Term Care Needs and Mortality

Kato, Daisuke; Kawachi, Ichiro; Saito, Tami et al.

Asia-Pacific Journal of Public Health, 2025

Number of Access:55（2026-02-18 22:05 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/103536

Link to primary information 

File Format Terms of use Size Views Date.Available Description information
Asia-PacJPublicHealth pdf None 218 KB 16 2026.01.05  
Creative Commons : Attribution - NonCommercial

Item Information

Output File Export EndNote Basic Export Mendeley

Title
Association of the 2018 Japanese Financial Incentive Policy With Long-Term Care Needs and Mortality
Creator
CreatorName
Kato, Daisuke
CreatorName
Kawachi, Ichiro
NRID
1000080323608 1000080323608
CreatorName
Saito, Tami
ORCID
0000-0002-9748-6793 0000-0002-9748-6793
researchmap permalink
yuichiyasufuku yuichiyasufuku
Scopus Author ID
58617692200 58617692200
CreatorName
Yasufuku, Yuichi
NRID
1000020345705 1000020345705
CreatorName
Kondo, Naoki
Description
Kato D., Kawachi I., Saito T., et al. Association of the 2018 Japanese Financial Incentive Policy With Long-Term Care Needs and Mortality. Asia-Pacific Journal of Public Health , (2025); https://doi.org/10.1177/10105395251400134.
Abstract
Japan launched a municipal financial incentive program in 2018 to promote higher-quality long-term care (LTC). We quantified the association between municipal incentive performance and subsequent incident LTC certification and all-cause mortality among community-dwelling older people. Baseline 2016 data from the Japan Gerontological Evaluation Study (N = 90 896 adults aged ≥65 years in 23 municipalities) were linked to 2018-2020 administrative records. Each municipality received a composite incentive score (0-612). Using multivariable logistic regression with fixed effects, we estimated odds ratios (ORs) per 1 SD score increase, adjusting for demographics, socioeconomic status, and health. Over three years, 10.7% newly required LTC certification and 5.1% died. A 1 SD higher incentive score was associated with lower odds of incident LTC (OR: 0.91, 95% CI [0.90, 0.92]) and all-cause mortality (OR: 0.66, 95% CI [0.54, 0.81]). These benefits were driven by the “Support Functional Independence/Prevent Progression” domain in less-urban areas, while plan-do-check-act–style activities predominated in cities. Overall, better municipal performance under Japan’s financial incentive policy correlated with short-term reductions in LTC utilization and mortality among older residents, supporting continued monitoring and policy refinement.
Publisher
SAGE Publications Inc.
Source Title
Asia-Pacific Journal of Public Health
Date of Issued
2025-12-24
Language
English
Handle URL
https://hdl.handle.net/11094/103536
PISSN
10105395
eISSN
19412479
Relation.isIdenticalTo
DOI (Publisher Version)
https://doi.org/10.1177/10105395251400134
Access Rights
open access
CopyRight
This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
oaire:version
Version of Record
Category
学術雑誌論文 Journal Article