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There are particular costs that lower the efficiency of providing home-visit long-term care services. These are the costs associated with the time taken to move between homes, such as labor costs and the expenditure incurred for the movement. These costs are collectively referred to here as “movement cost”. To ensure stable business operation, to ensure efficient use of social insurance funding, and to increase service efficiency, it is necessary to examine movement cost and other fixed costs, as well as all associated costs. In this study, we constructed a model for the income and expenditure ratio of a home-visit long-term care service business,by using movement time,and the main determining factor of movement cost, as a variable in order to investigate the influence of movement time on business performance. In addition, we conducted a sensitivity analysis by varying certain parameters to assess the degree of influence on the income and expenditure ratio. The results demonstrated that a change in the part-time worker fraction can lead to the conditions where the impact of movement time on the income and expenditure ratio precipitates a catastrophic change in business profitability . This result suggests that collective housing, which requires little movement, is a more efficient solution than home-visit care for providing local community-based nursing care for the elderly. <Key-words> movement cost, income and expenditure ratio, long-term care insurance system, home-visit long-term care service, catastrophic change hsasaki.csw.office@gmail.com(Hitoshi SASAKI) Asian J Human Services, 2015, 8:34-50. © 2015 Asian Society of Human Services Received

Impact of Movement Cost on Income and Expenditure Ratio in Home-Visit Long-Term Care Service Businesses in Japan