Problems of integration of medical care and welfare service: medical treatment under long-term insurance system

摘要

The advent of the long-term care insurance system has brought substantial structural change not only in the social welfare field but also to the medical care system. Long-term care insurance has also been introduced into the geriatric hospital system to reduce medical care insurance expenditure. As a result, in cases of emergency involving people under long-term care, adequate medical care can not be expected because of a shortage of medical treatment wards for the aged. At a sanatorium-type hospital, the upper limit of the insurance payment is decided by the care degree required by the patient. So from the standpoint of the hospital management, it is-necessary to admit patients requiring more severe degrees of care to a sanatorium-type hospital. It has become difficult to hospitalize dementia patients requiring care degrees 1 or 2. Under the long-term care insurance system, the problem of medical treatment for the aged becomes all the more serious.