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In order to formulate practical indications for the future Japanese health reform programs, we have conducted a structural analysis of the factors associated with increase in health expenditures for the aged based on the claim data of National Health Insurance (NHS) scheme of one local government, Kyushu, Japan. Total Health Care Expenditures (THCE) of this city increased 5.00% between 2000 and 2001, of which 5.64 % was due to the increase of aged insured, and on the contrary per capita Health Care Expenditures (pHCE) showed negative contribution; –0.64%. For changes in the three factors of pHCE, utilization rate and day per case decreased –1.00% and –2.73% respectively, and on the contrary expenditures per day increased 2.96%. The present analysis has indicated that the rapid ageing of the Japanese society is the most important factor for increase of THCE. In order to realize a healthy aged society and to make our system sustainable, one of the possible solutions is to strengthen the health promotion program. It is expected that the newly introduced national health promotion program from 2008 will contribute to the development of healthy aged society.

Structural Analysis of the Factors Associated with Increase in Health Expenditures for the Aged in Japan