ArticleBMC geriatrics2020
Effect of reduced formal care availability on formal/informal care patterns and caregiver health: a quasi-experimental study using the Japanese long-term care insurance reform.
Article in BMC geriatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 43 citations in OpenAlex.
- Identifying the factors influencing long-term care utilization by older adults in China: machine learning analysis.BMC geriatrics · 2026Article
- Impact of caregiving burden on family caregivers of older adults with chronic diseases.Frontiers in psychiatry · 2026Article
- Development of the nursing practice scale to enhance resilience in family caregivers and evaluation of its reliability and validity.BMC nursing · 2025Article
- Preferences for home-based care services during China's long-term care market transition: evidence from a discrete choice experiment.BMC health services research · 2025Article
- Who came to the rescue? Sources of informal support to older Europeans before, during and after the COVID-19 pandemic.Age and ageing · 2025Article
- The impact of long-term care insurance on household expenditures of the elderly: Evidence from China.PloS one · 2025Article
- The Unseen Shift: How Partnership Long-term Care Insurance Influences Caregiving Among Older Adults.The journals of gerontology. Series B, Psychological sciences and social sciences · 2024Article
- Article
- Effect of long-term care insurance policy on depression in non-disabled people: evidence from China.BMC public health · 2024Article
- Health effects of long-term care insurance on spouses of disabled people: a quasi-experimental study.BMC geriatrics · 2023Article
- Health spillover studies of long-term care insurance in China: evidence from spousal caregivers from disabled families.International journal for equity in health · 2023Article
- Associations between long-term care-service use and service- or care-need level progression: a nationwide cohort study using the Japanese Long-Term Care Insurance Claims database.BMC health services research · 2023Article
- Impact of Economic Accessibility on Realized Utilization of Home-Based Healthcare Services for the Older Adults in China.Healthcare (Basel, Switzerland) · 2021Article
- Family caregiving and changes in mental health status in Japan during the COVID-19 pandemic.Archives of gerontology and geriatricsArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundIt is unclear how formal long-term care (LTC) availability affects formal /informal caregiving patterns and caregiver health. We tested the impact of reduced formal LTC availability on formal LTC service use, intensity of informal caregiving, and caregiver health.
methodsUsing a representative, repeated cross-sectional sample of Japanese caregivers providing care to co-resident family members from 2001 to 2016, we applied a difference-in-differences approach by observing caregivers before and after the major reform of the public Japanese LTC insurance (LTCI) in 2006. The reform reduced coverage benefits for non-institutionalized older persons with low care needs, but not for those with high care needs. We analyzed 12,764 caregivers aged ≥30 years (mean age 64.3 ± 11.8 years, 73.5% women) and measured indicators of formal LTC use, hours of informal caregiving, and caregiver self-reported health outcomes after propensity score matching to balance caregivers' background characteristics.
resultsWe found the 2006 LTCI reform relatively reduced the use of formal LTC services and relatively increased the percentage of experiencing long hours of informal caregiving (> 3 h per day) among the caregivers for seniors with low care needs compared to those for seniors with high care needs. The effects of the LTCI reform for the caregivers for seniors with low care needs were 2.2 percentage point higher on caregivers' experiencing poor self-rated health (95% confidence interval [CI]: 0.7-3.7; p = 0.01), 2.7 percentage point higher on experiencing symptoms of a depressive state (95%CI: 0.5-4.8; p = 0.03), and 4.7 percentage point higher on experiencing symptoms of musculoskeletal diseases (95%CI, 3.6-5.7; p < 0.001), compared to those for seniors with high care needs.
conclusionsReduced formal care availability under the Japanese LTCI reform increased hours of informal caregiving corresponding to reduced use of formal LTC and deteriorated multiple dimensions of caregiver health. Our findings may highlight the importance of enhancing the availability of formal LTC services for caregiver health.
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