Abstract

Objectives: Japan and Sweden are similar from many respects with regard to LTC needs and public responsibility to meet these needs. Thus population aging is expected to result in increase of LTC costs in both Japan and Sweden. The study aims to calculate projections of costs of LTC in the period 2010 – 2040 under different assumptions regarding changes in population, needs of LTC by age-group and gender, provided services by level of need and cost of LTC services in Japan and Sweden.

Data and methods: Population data were taken from the official national forecasts. The needs projections were based on epidemiological data, the Japanese NUJLSOA and the Swedish SSLC (ULF). Japanese data on LTC services provision by needs and costs for services were taken from nine municipalities collected by assessments in the LTCI-system. Corresponding Swedish data were from surveys in eight Swedish municipalities made for the national tax equalization scheme. The total initial costs were calibrated to agree with official national figures.

Results: Two different projections are made for each country – one assuming unchanged dependency by age group and gender, the other assuming that present dependency trend is continued until 2025. For Japan this results in a projected cost increase of 93% and 80% respectively from 2010 to 2040, for Sweden 52% and 24% respectively. The results reflect differences in population aging and health development.

Policy implications: The analysis shows that there are substantial demographic and economic challenges facing both countries in the coming decades. The health development by age-group and gender is a crucial factor for the sustainability of the LTC system putting emphasis on the need for successful health promotion and disease prevention. Better decision support is needed to guide policy in this area of the welfare state. This is a task that could benefit from future co-operation between the two countries.