Changing location and service area of day service centers after the introduction of the long-term care insurance system: Case study of Fujisawa City, Kanagawa Prefecture, Japan

Abstract

After the introduction of the long-term care insurance system in April 2000, the utilization of welfare facilities for the elderly has changed. The use of day service centers is possibly the biggest change brought about by the long-term care insurance system. The effect of the measures adopted by the administration has especially influenced the location of facilities used before the start of the new long-term care insurance system. However, after the institutionalization of the long-term care insurance system, it became possible for users to select a facility freely. This paper clarifies the changing location and service area of day service centers after the inception of the long-term care insurance system. This was difficult using conventional methods applicable to the municipality level since the service area of the centers occupies only a small part of the city, the residence wards. After the long-term care insurance system began operation, the number of private facilities with small capacity increased. The service area of day service centers changed mainly to the extent that the facilities expanded. As a result, competition is occurring among the day service centers at the residence ward level, and the era of free competition has arrived even in the welfare-related industry in Japan.