Table Of ContentHuman Services and
Long-term Care
Providing human service through markets is inherently problematic. Quality care
is critical, and unsatisfactory human service greatly influences people’s quality of
life. Yet, profit for human service providers is essential for sustainable service
provision. This book focuses on striking a balance between human services’ need
for quality assurance and market providers’ need for profit.
Yoshihiko Kadoya is Director of the Hiroshima Institute of Health Economics
Research (HiHER) and Associate Professor of Economics, Hiroshima University,
Japan.
Routledge Studies in the Modern World Economy
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169 Financial Reform in China
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170 Economic Integration and Regional Development
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172 Indian Agriculture after the Green Revolution
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173 Credit Default Swap Markets in the Global Economy
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174 The Economic Development of South Korea
From Poverty to a Modern Industrial State
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175 Human Services and Long-term Care
A Market Model
Yoshihiko Kadoya
Human Services and
Long-term Care
A Market Model
Yoshihiko Kadoya
First published 2018
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© 2018 Yoshihiko Kadoya
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work has been asserted by him in accordance with sections 77 and
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British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Names: Kadoya, Yoshihiko, author.
Title: Human services and long-term care : a market model /
by Yoshihiko Kadoya.
Description: Abingdon, Oxon ; New York, NY : Routledge, 2018. |
Series: Routledge studies in the modern world economy ; 175 |
Includes bibliographical references and index.
Identifiers: LCCN 2017054686 | ISBN 9781138630932 (hardback) |
ISBN 9781315209159 (ebook)
Subjects: LCSH: Older people—Long-term care. | Older people—
Services for. | Human services. | Caregivers.
Classification: LCC RA564.8 .K33 2018 | DDC 362.16—dc23
LC record available at https://lccn.loc.gov/2017054686
ISBN: 978-1-138-63093-2 (hbk)
ISBN: 978-1-315-20915-9 (ebk)
Typeset in Galliard
by Apex CoVantage, LLC
Contents
List of figures vii
List of tables ix
Preface xi
Introduction: the human service age and
new economics 1
1 Studying human service provision through
competitive markets 12
PART I
Care market model for the human service market 31
2 The care market model 33
3 Verifying the implementability of the care
market model 43
4 Verifying the implementation effects (efficacy) of the
care market model 54
5 Verifying the financial sustainability of the care
market model 76
PART II
Performance measurement for the human service market 87
6 Outcome-based and process-based performance
measurement model for the human service market 89
7 Investigating the empirical applicability of process-based
performance measurement in human services provided
through a competitive market 101
vi Contents
8 Care workers’ training 124
9 An industrial policy to ensure the sustainability
of the care market model 138
10 Conclusion: “managing the human service market”
originating from Japan 158
References 169
Index 180
Figures
0.1 Share of very old people (aged 80+) in the populations
of selected OECD members 5
1.1 Public and private expenditure on long-term care as a
percentage of GDP 17
1.2 Correlation between total long-term care spending and
the population share of very old people (aged 80+) 17
1.3 Correlation between total long-term care spending and
population share of older people (aged 65+) 18
1.4 Share of very old people (80+ years) in the population,
1960 to 2040 18
1.5 Female labor force participation rate 20
2.1 Care differentiation and equilibrium 35
3.1 LTCI benefits and sources of funds 44
3.2 Overall process of LTCI benefits 45
4.1 Transition of market share by type of provider (as of October
in each year) 56
5.1 Correlation between public long-term care spending and
population share of very old people (aged 80+) 77
5.2 Care differentiation and equilibrium 83
5.3 Flow chart of the CMM 84
6.1 Current structure of Public Administration Model 97
6.2 Traditional structure of Public Administration Model 97
6.3 Hierarchical interaction in logic of governance 98
6.4 Care policy model 99
7.1 Percentage of population aged 65 years and above 106
7.2 Percentage of bedridden people by bedridden periods 107
7.3 Future estimation of the bedridden elderly/elderly people
suffering from dementia 108
7.4 Caregivers for the bedridden elderly (age group) 108
7.5 Caregivers for the bedridden elderly (male vs. female) 109
7.6 Female labor participation ratio in Japan 109
7.7 How to become a certified care manager 113
7.8 How to be an evaluator 115
viii Figures
7.9 A standard weekly at-home care plan (Support 1–Care 5) 117
7.10 Direct-care workers’ low wages 120
7.11 Direct-care workers lacking health coverage 121
8.1 Differences in long-term care schemes in the
United States and Japan 126
8.2 Six routes to qualify as a certified care worker 132
8.3 Career paths of certified care workers in Japan 135
8.4 Number of registered certified care workers 136
9.1 Estimated spending on LTCI 139
9.2 View of desired long-term care 140
9.3 Robot Revolution Initiative 141
9.4 Overall Japanese robot industry market prediction
(2015–2035) 148
9.5 Interest rates of Japanese government bonds (10 years) 150
9.6 Share of Japanese government bonds holders
(total: 755 trillion yen, March 2011) 152
9.7 Share of Japanese government bonds holders
(total: 959 trillion yen, December 2016) 152
9.8 Ratio of certified care workers at work 156
10.1 Flow chart of CMM 159
Tables
0.1 The speed of the shift from aging to aged society in
East Asian nations 4
1.1 Introduction of universal suffrage, selected countries 13
1.2 Public and private expenditure on long-term care as
a percentage of GDP 16
1.3 Old age-dependency ratio (1960–2040) 19
1.4 Benchmark events in the history of long-term care policies
in selected countries (1965–2000) 21
1.5 Long-term care provision by the private sector in
selected countries 23
1.6 Care quality assurance policies for long-term care provision
in OECD countries 24
1.7 The ideas of new public management 27
1.8 Transformation of Public Administration Model 28
2.1 Major public long-term care program in 19 selected
OECD member countries 38
3.1 Approximate standards of the seven grades 46
3.2 LTCI beneficiaries by grades (as of April 2006) 47
3.3 Benefit limit of each grade 47
3.4 Choice of major care services 47
3.5 Cost of group homes for elderly with dementia 48
3.6 Care quality evaluation programs 50
3.7 Index of mandatory third-party evaluation 52
4.1 Distribution of providers by ownership 59
4.2 Mandatory third-party evaluation 60
4.3 Total variance explained 62
4.4 Component matrix 63
4.5 Descriptive statistics 65
4.6 Comparison of service quality by ownership of providers 66
4.7 Distribution by ownership of providers 67
4.8 Influence of other variables 68
4.9 Distribution by market competitiveness of providers 69
