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Direct and indirect costs of home healthcare in Japan: A cross‐sectional study
Author(s) -
Tomita Shiori,
Hoshino Eri,
Kamiya Keisuke,
Yasuhiro Osugi,
Rahman Mahbubur
Publication year - 2020
Publication title -
health and social care in the community
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.984
H-Index - 68
eISSN - 1365-2524
pISSN - 0966-0410
DOI - 10.1111/hsc.12945
Subject(s) - health care , indirect costs , medicine , cross sectional study , absenteeism , interquartile range , total cost , environmental health , medical expenditure panel survey , business , health insurance , surgery , accounting , management , pathology , economics , economic growth
To tackle the rising healthcare expenditure in an ageing society in Japan, home healthcare has been promoted over the past several years. However, there is a dearth of literature on total costs incurring for home healthcare. In this study, we conducted a cross‐sectional study among patients, who received home healthcare in the month of May, 2018. Direct healthcare costs and patients’ clinical characteristics were collected from medical records and long‐term care databases ( n  = 166). Indirect costs were estimated using a questionnaire survey which obtained information on job absenteeism and care time from the caregiver. A total of 112 patients responded to the survey. The median age was 82 years (interquartile range: 74–88). Total per‐person per month home‐care costs averaged USD 6,163 with direct costs (USD 2,547) and indirect costs (USD 3,596) accounted for 41.3% and 58.3% of the total costs, respectively. The largest components of direct costs were long‐term care costs (48%) and medical costs (47%). Multivariable adjusted model showed that those with heavy healthcare were more likely to incur higher total as well as direct and indirect home healthcare cost ( p <.05 for each). Patients aged >75 years ( p  = .041) were less likely and those who used oxygen at home were more likely to incur direct home healthcare cost ( p  = .001) than their counterpart. Our study findings show that indirect cost is a major contributor to total home healthcare costs in Japan. Also for patients who need heavy healthcare, both direct and indirect costs are large burden.

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