Revision of Nursing Care Fees Discussion Difficulty Hits Business Administration in Corona November 7, 18:52

The new coronavirus is having a major impact on the management of long-term care establishments.

The government is currently discussing the revision of the "nursing compensation" paid to business establishments, but there are a number of voices from the field calling for an increase in compensation.

On the other hand, the Ministry of Finance and others have expressed cautious opinions about raising the price, and it is expected that discussions will be difficult.

In the field of long-term care, due to the spread of the new coronavirus infection, elderly people who are afraid of infection are refraining from using it, and business establishments are moving to limit the number of people to reduce the risk.



As a result, the number of users has decreased and the management of long-term care establishments has deteriorated.



According to a survey conducted by the Ministry of Health, Labor and Welfare at approximately 40,000 business establishments nationwide, as of May, 47.5% of respondents answered that their income and expenditure had worsened compared to before the virus epidemic, and as of October, 32.7%. It went up to about one-third.



Most of the income of these long-term care establishments is the "long-term care fee" paid by the local government as compensation for providing long-term care services.



Nursing care fees are revised once every three years for each service, and the council of the Ministry of Health, Labor and Welfare is currently in full swing to discuss the revision in April next year.



Regarding this, there are a number of voices from nursing care establishments calling for an increase in remuneration, such as "I was originally forced to manage hard, but I was hit further by the new corona, and I can not continue the business as it is."



On the other hand, there are some cautious opinions about raising the price.



At the council meeting held on the 2nd of this month, the Ministry of Finance said that raising the remuneration would increase the burden on users, and while the severe impact on the economy would spread, there is no environment to raise it. I am proposing.



As the cost of long-term care continues to rise due to the aging of the population, how far will we improve the management of long-term care establishments?


The council plans to finalize the policy by the end of the year, but discussions are expected to be difficult.

What is the long-term care insurance system?

The nursing care insurance system started in 2000 (2000), and it has been 20 years since then.



Due to the aging of the population, the number of people in need of long-term care has tripled since the start of the system.



Along with this, the necessary expenses have more than tripled, and in FY2018 (FY2018), excluding the self-pay portion, it amounted to 10.2 trillion yen.



Furthermore, it is estimated that by 2025, when all baby boomers will be 75 years old, it will reach about 15 trillion yen, excluding the self-pay portion, and by 2040, when the aging peaks, it will reach about 25 trillion yen.



On the other hand, the number of working generations who support the system is expected to decrease, and while the national budget deficit is serious, how to control the growth of long-term care costs and maintain the system is an urgent issue. ..



Against this background, the review of nursing care remuneration once every three years resulted in a significant negative revision of minus 2.27% in 2015, the previous year, and plus 0.54% in the previous year 2018, but the day service Severe revisions have continued, such as lowering compensation at large-scale business establishments.

Current status of day service

Among the long-term care services, "outpatient care" such as day service is particularly strongly affected by the new coronavirus.



As a result of a survey of more than 1,700 business establishments nationwide by the Ministry of Health, Labor and Welfare, as of the end of July, 81.7% of business establishments answered that "there were elderly people who refrained from using the service."



As a result, the number of outpatient long-term care users per establishment decreased by an average of 10.9% in May compared to the previous year, and decreased by 4.4% in August.



The day service "Aobadai Sakuraen" in Meguro-ku, Tokyo is also one of the offices facing severe management due to a decrease in users.



Originally there were 40 users here, but in March, due to the spread of infection in Japan, in order to prevent three crowds, we changed the arrangement of desks so that users can secure a distance of 1 meter and increased the capacity. I reduced it to 25 people.



Even so, a number of elderly people refrained from using the service because they were afraid of infection, and in April the number of users reached 15.



After that, although the usage has gradually returned, it is still only 19 people.



While income will decrease as the number of users decreases, costs will be high, such as installing acrylic plates between seats and purchasing tablet terminals for online interaction in order to strengthen infection control. I will.



In addition, we plan to refurbish the serving table so that tableware can be disinfected frequently, and the cost of infection control is expected to exceed 2 million yen.



Shingo Maruyama, the administrator of the day service, said, "Originally, the management was tough, but if the usage refrains continue, it will become even more severe and there is a risk of falling into the red."



Sonouede "Tokyo is not stand the prospect of infection convergence, severe run Efforts have been made in our desire to support somehow still it continues seen in. Life of the elderly, to improve the management in only their own devising I feel that there is a limit to what I can do, and I want you to improve your rewards. "

Expert "This time we should increase the amount firmly and support the business operator"

Associate Professor Toshihisa Hayasaka of Toyo University, who is familiar with nursing care sites, said, "The negative revisions in the past were too large, and although the previous revision was a small positive revision, the condition of water was on the burnt stones. Due to the addition and refraining from using the service, the long-term care service is not working well, further deteriorating the management of the business establishment. "



On top of that, "If we don't really think about how to support long-term care in the future, we will be in an era where there is no service even if there is a long-term care system. With this remuneration revision, we will firmly support the negative revisions so far. I think we should increase the amount to prevent the outflow of human resources and support businesses. "