Abstract:
:Japan implemented a mandatory social long-term care insurance (LTCI) system in 2000, making long-term care services a universal entitlement for every senior. Although this system has grown rapidly, reflecting its popularity among seniors and their families, it faces several challenges, including skyrocketing costs. This article describes the recent reform initiated by the Japanese government to simultaneously contain costs and realize a long-term vision of creating a community-based, prevention-oriented long-term care system. The reform involves introduction of two major elements: "hotel" and meal charges for nursing home residents and new preventive benefits. They were intended to reduce economic incentives for institutionalization, dampen provider-induced demand, and prevent seniors from being dependent by intervening while their need levels are still low. The ongoing LTCI reform should be critically evaluated against the government's policy intentions as well as its effect on seniors, their families, and society. The story of this reform is instructive for other countries striving to develop coherent, politically acceptable long-term care policies.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Tsutsui T,Muramatsu Ndoi
10.1111/j.1532-5415.2007.01281.xsubject
Has Abstractpub_date
2007-09-01 00:00:00pages
1458-63issue
9eissn
0002-8614issn
1532-5415pii
JGS1281journal_volume
55pub_type
杂志文章,评审abstract::Many physicians report that Internet health information can affect their clinical decisions. Much of Internet geriatric health information (IGHI) is not controlled for quality, and there is no available process to assess the quality of IGHI used in clinical practice or in medical education. The objective of this proje...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53272.x
更新日期:2005-05-01 00:00:00
abstract::Osteochondritis dessicans of the hip is rare in comparison with occurrence of the disease in other joints. Only about 50 cases have been reported. The literature is reviewed, and a new case is presented. The patients was a 94-year-old Spanish American War Veteran who was unusally active and in good health until the on...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00535.x
更新日期:1980-06-01 00:00:00
abstract:OBJECTIVES:To examine the relative effect of comorbidities, noncancer symptoms, and cancer-related factors on the functioning of older adult long-term survivors of breast, colorectal, and prostate cancers. DESIGN:Data from in-person interviews with survivors of a tumor registry-based stratified random sample were used...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02515.x
更新日期:2009-11-01 00:00:00
abstract::A 66-year-old male patient who had undergone repeated operations for peptic ulcer disease involving the right upper abdominal quadrant, developed cholecystitis with calculous obstruction of the common bile duct. The gallbladder was removed. Later, an operation was performed for removal of a residual stone from the com...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1976.tb03283.x
更新日期:1976-12-01 00:00:00
abstract:OBJECTIVES:To elucidate the relationship between stroke and depressive symptoms and to determine whether disability or cerebrovascular risk factors mediate that relationship. DESIGN:A prospective longitudinal epidemiological survey. SETTING:The mid-Monongahela Valley, a rural, nonfarm, low-socioeconomic-status commun...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52217.x
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVES:To identify differences in cognitive function between elderly adults with sleep apnea syndrome (SAS) and healthy controls. DESIGN:Cross-sectional. SETTING:Sleep laboratory at Seoul National University Bundang Hospital. PARTICIPANTS:Sixty-three elderly adults (26 female; mean age 68.2 ± 4.8) without cognit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.03961.x
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:To examine the effects of caring for a spouse with dementia on the caregiver's risk for incident dementia. DESIGN:Population-based study of incident dementia in spouses of persons with dementia. SETTING:Rural county in northern Utah. PARTICIPANTS:Two thousand four hundred forty-two subjects (1,221 married...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02806.x
更新日期:2010-05-01 00:00:00
abstract::The drugs prescribed for long-term use by 56 elderly patients while they were under domiciliary care in a municipal hospital were compared with the drugs prescribed for the same patients six months after they had moved to a city nursing home. All patients were at least 65 years old, and were in the hospital for at lea...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb02251.x
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVES:To compare the quality of end-of-life care in Medicare Advantage (MA) and traditional Medicare (TM), specifically, receipt and length of hospice care. DESIGN:Retrospective analysis of administrative data. SETTING:Hospice care. PARTICIPANTS:Veterans dually enrolled in the Veterans Health Administration (VH...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15434
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:To evaluate the relationship between frailty and delirium. DESIGN:Systematic review and meta-analysis. SETTING:MEDLINE, EMBASE, PubMed, Scopus, Web of Science, and Google Scholar databases were searched for articles on frailty and delirium published on or before October 31, 2017. PARTICIPANTS:Individuals ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析
doi:10.1111/jgs.15503
更新日期:2018-10-01 00:00:00
abstract::Little is known about the unmet mental health needs of minority older adults. Racial and ethnic differences in the prevalence rates of psychological distress and reported need and use of mental health services were examined in a population-based sample of older adults using the 2005 California Health Interview Survey....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02573.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVES:To quantify the prevalence of documented urinary tract infection (UTI), nonspecific symptoms, and antibiotic treatment of suspected UTI in nursing homes (NHs) in the tropics and to describe the typical resident likely to receive antibiotic treatment for suspected UTI and factors associated with the developme...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15179
更新日期:2018-02-01 00:00:00
abstract::The Wisconsin Drug Utilization Review Project used Medicaid claims data to examine the use of long-term, full doses histamine-2 receptor antagonists (H2RAs) among long-term care facility (LTCF) residents, ie, doses exceeding 800 mg per day of cimetidine or 150 mg per day of ranitidine for 12 weeks or more. Additional ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb04024.x
更新日期:1988-06-01 00:00:00
abstract::Leaders of geriatric programs at academic health centers (AHCs) face several challenges in seeking support for clinical program development. These challenges relate to how revenues from Medicare activities flow within AHCs. Typically, clinical departments such as the Department of Medicine see a very small proportion ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50174.x
更新日期:2002-04-01 00:00:00
abstract::Logical bases (five of which are outlined) underlie action in nutrition and aging. First, nutrition, health, and aging form an integral triad affecting all. This basis has been applied to the conceptualization of the Nutrition Program for Older Americans (NPOA). Second, in North America, malnutrition is a sequitur of ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb01958.x
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVES:To describe the prevalence of visual and auditory impairment in frail older persons and to evaluate the association between sensory impairment and overall functional status. DESIGN:Prospective patient evaluation and retrospective analysis of data. SETTING:The outpatient geriatric assessment clinic of a uni...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb07432.x
更新日期:1999-11-01 00:00:00
abstract::Delirium is a common and serious condition that is underrecognized in older adults in a variety of healthcare settings. It is poorly recognized because of deficiencies in provider knowledge and its atypical presentation. Early recognition of delirium is warranted to better manage the disease and prevent the adverse ou...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.12522
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:Poor diet due to poor oral health was proposed as a potential mediator of the association between poor oral health and frailty. This study explores the cross-sectional associations between poor oral health, poor diet, and frailty in Canadian adults, aged 45 to 85 years, and then tests whether the expected or...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16377
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:Medicare value-based payment programs evaluate physicians' performance on their patients' annual Medicare costs and clinical outcomes. However, little is known about how geriatricians, who disproportionately provide care for medically complex older adults, perform on these measures. DESIGN:A retrospective s...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16297
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN:Randomized clinical trial. SETTING:Primary care clinics at a Veterans Affairs Medical...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.15042
更新日期:2017-10-01 00:00:00
abstract::This study was undertaken to identify the demographic characteristics of patients aged 55 or older in a drug-overdose group admitted to the Emergency Department of Arizona Health Sciences Center during the 3-year period, August 1975-July 1978. Of the 646 overdose patients observed, 60 (9.5 percent) were aged 55 or old...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00004.x
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVES:To estimate in a community-dwelling elderly population the magnitude of renal function misclassification, occurring when persons with normal serum creatinine have reduced glomerular filtration rate (GFR), and to describe the participant characteristics related to misclassification. DESIGN:Cross-sectional. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01196.x
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:To estimate the cost-effectiveness of an intervention to increase pneumococcal, influenza, and pertussis-containing vaccine uptake in adults aged 65 and older in primary care practices. DESIGN:Markov decision analysis model, comparing the cost-effectiveness of the 4 Pillars Practice Transformation Program w...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/jgs.14588
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:To determine the cross-sectional and longitudinal associations between 25-hydroxyvitamin D (25(OH)D) levels and frailty status in older men. DESIGN:Prospective cohort study. SETTING:Six U.S. community-based centers. PARTICIPANTS:One thousand six hundred six men aged 65 and older. MEASUREMENTS:25(OH)D (li...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.03201.x
更新日期:2011-01-01 00:00:00
abstract::Given the American Geriatrics Society's (AGS) commitment to improving health care for older adults by, among other means, educating older people and their caregivers about their health and healthcare choices, the AGS was delighted when, in late 2011, the American Board of Internal Medicine Foundation invited the Socie...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12226
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:To determine the trajectory of handgrip strength (HGS) from age 70 to 90 and its association with mood, cognition, functional status, and mortality. DESIGN:Prospective follow-up of an age-homogenous representative community-dwelling cohort (born 1920-21) in the Jerusalem Longitudinal Cohort Study (1990-2015...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14509
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To determine if alcohol use is a risk factor for fall injury events among community-dwelling older persons. DESIGN:Case-control study. SETTING:South Miami Beach, Florida. PARTICIPANTS:320 persons 65 or older who sought treatment at six area hospitals for injuries resulting from falls; 609 controls, matched...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb01955.x
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVES:To assess the efficacy of a leg exercise performed in supine position to prevent orthostatic hypotension (OH) in older adults. DESIGN:Case-control study. SETTING:Division of Physical Medicine and Rehabilitation, Salvatore Maugeri Foundation, Scientific Institute of Veruno, Veruno, Italy. PARTICIPANTS:Indi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12313
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Little is known about elder abuse and neglect in the lesbian, gay, bisexual, and transgender (LGBT) community; however, this population faces a greater risk of abuse and likely experiences abuse differently and needs different resources. We conducted focus groups to investigate LGBT older adults' ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.16101
更新日期:2019-11-01 00:00:00
abstract::As part of a study of long-term institutional care of the elderly, this report presents salient data concerning 193 elderly applicants. Physicians play an important role in decisions to apply for such care. More than half of the applicants and about 80% of their family members approved of the proposed move. The number...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1976.tb04293.x
更新日期:1976-04-01 00:00:00