Destination after discharge from a senile dementia therapy ward before and after the implementation of long-term care insurance in Japan

Background:  In Japan a new long-term care insurance (LTCI) system, the so-called ‘Kaigo-Hoken’, was started in April 2000. The present study analyzes the change in the type of destination after discharge from a senile dementia therapy ward before and after the implementation of LTCI at Fukuoka Prefectural Onga Hospital, Japan. Methods:  The present study examines data from 199 inpatients discharged from the Fukuoka Prefectural Onga Hospital that had been diagnosed with dementia and met the DSM IV criteria for Alzheimer's type, vascular dementia or other type of dementia. For the purposes of comparison two periods were defined, ‘the first period’ was defined as the period from 1 April 1999 to 31 March 2000, before LTCI was implemented, while ‘the second period’ was defined as the period from 1 April 2000 to 31 March 2001, after LTCI had started. Subject data was analyzed on the basis of where the subject had resided pre-admission and their destination after discharge using the following classifications: nursing home or geriatric care facility, hospitalization, home and death. Results:  While the certification rate of inpatients regarding long-term care increased slightly in the second period, no significant change was observed based on where the subject had resided pre-admission and their destination after discharge between the first and second periods. Conclusions:  While LTCI is essential for Japan, it is necessary that people with dementia in senile dementia therapy wards are encouraged to return to their homes under the care and support of LTCI.