THE LOCATION TREND OF DAY SERVICE FACILITIES AND THE LEVEL OF SUFFICIENCY BY USE SPHERE IN YAMAGUCHI PREFECTURE Mari CHIHARA1, Mahito NAKAZONO2 and Sachiko YAMAMOTO3 1 Faculty of Eng., Yamaguchi Univ. 2 Prof., Graduate School of Science and Eng., Yamaguchi Univ., Dr. Eng. 3 Assistants Prof., Graduate School of Science and Eng., Yamaguchi Univ., Dr. Eng. KEYWORDS: Health coverage system, Day service for old people, Facilities location, Use sphere ABSTRACT: This paper aims at explaining the location trend of day service facilities and the change in time series of the sufficiency level by use sphere after the health coverage system was introduced. The results are as follows. 1) Though the number of facilities construction before the introduction of care insurance system was about 3-10 facilities/year, the number increased rapidly with about 40 facilities/year after 2000. And the small-scale facilities in the capacity of less than 10 people are on the increase drastically in place of the facilities in the capacity of 11-30 people around the large-scale area after the care insurance law revision in 2006 which the promotion of supply of small scale multiple functions type was decided. 2) The aging rate and sufficient rate are similar to about 25% in the large-scale area, but the difference is seen in the middle scale area in 20-30% of aging rates and 15-40% of sufficient rates. 3) Though the aging rate exceeds 40% in the small-scale area in the cities of half, the sufficient rate is large before and after 20%, so the rate is low relatively. But, it was shown that an area (ABU-cho) existed with 37% of sufficient rate by forming the network of one large facility and three small facilities. 1. INTRODUCTION on was revised (2000), and (1) construction of the 1.1 BACKGROUND OF THE RESEARCH social welfare system made in the user's standpoint It proceeded with the reform of the social (2) improvement in the quality of the service (3) welfare system from the latter half of 1980 years fulfillment and activation of the social service (4) fee, the decision of the new gold plan that the increase in area welfare were made the pillar of the emphasis was put for the service base maintenance law. With revision care insurance law (2006), it (1994), the formation of care insurance law(1997), changes into the policy of the prevention emphasis, and the gold plan 21 (1999) that the basis was put the establishment of the area inclusion center to on at-home welfare was settled on based on the provide the care preventive service and the contents health coverage system. Next year, the health that maintenance such as a small scale multiple coverage system was introduced to attempt functions type care office caused by the start of the strengthening of the area welfare support system area close adhesion type service by the local (2000), at the same time, social welfare law was governments was promoted were included (table 1) . concluded and social welfare business law and so The repair condition of the old people day service facilities of the whole country after 2001 is shown Table.1 Senior citizen welfare policy chronology of in the figure 1. As for the number of facilities, it Japan doubles in 21,000 facilities in 2007 from 9,000 in 『Senior citizen health welfare promotion ten year strategy』 1989 (Gold plan) 2001, and it is understood that the maintenance is 1994 《New gold plan》 1997 『Care insurance law』 proceeding rapidly. About the management subject, 《Social welfare basic structural reform》 1999 《Gold plan 21》 though the social welfare corporation which became Social welfare law The health coverage system the center from before occupied 5000 facilities and When the person who exists in the state of needing care or 2000 the state of the support necessary uses the nursing service, majority in 2001, after the introduction of the health not only insurance that collects the cost (supply expense) from the insurant but also the country, administrative coverage system, the entering of the profit-making divisions, and the municipality bear responsibility. Revision care insurance law corporation has been increasing rapidly, and the It converts to the policy of a preventive valuing. The maintenance such as the small-scale, multifunctional type number reached 7000 facilities in 2007, and the 2005 nursing offices according to beginning of community-based service by the establishment of the region inclusive center point that management by NPO which wasn't hardly that provides the preventive approach in long term care seen in 2001 shows a tendency to increase is service and the municipality is promoted. pointed out as the characteristics. 25000 Others Cooperative society Corporation and foundation 20000 Local public entity 1.2 THE PURPOSE AND METHOD NPO Medical corporation For Yamaguchi Prefecture where the decrease Social welfare council 15000 Profit-making corporation Social welfare corporation in population and the progress of aging are nationwide remarkable, this paper aims at 10000 explaining the location trend of old people day Corporation and foundation 5000 service facilities after the health coverage system (2000) introduction to support care for home and 0 2001 2002 2003 2004 2005 2006 2007 the change in time series of the level of sufficiency Age by the area stage. Fig.1 The repair condition of the old people day The method of research is that local governments service facilities of the whole country are classified by the index of change of population and aging rate, and the changes of the aged Abu-cho population are put in order by the type, and the next, Ato-cho the classification of old people day service facilities Nagato-city Hagi-city repair process of Yamaguchi Prefecture is done, and Waki-cho Mine-city Yamaguchi-city Shimonoseki-city Iwakuni-city facilities repair conditions are put in order by the Syuunan-city Houhu-city type. The level of sufficiency of the day service Sanyoonoda-city Yanai-city Ube-city Kudamatsu-city Hikari-city Tabuse-cho facilities to the old people population is grasped Hirao-cho Suo-oosima-cho more, and relations between the population change Kaminoseki-cho type and the repair process type are put in order. Fig.2 Yamaguchi prefecture complete map 2. THE OLD PEOPLE POPULATION Total population, old people population and CHANGE OF Yamaguchi Prefecture aging rate change from 1985 until 2035 is shown in 2.1 THE POPULATION CHANGE AND the figure 3 with the census and population TREND OF AGING prediction data by the Institute of Population Problems. The total population of Yamaguchi 1800000 40 Prefecture shows a tendency to decrease from 1,6 1600000 35 1400000 00,000 people in 1985, and it has predicted that it 30 1200000 25 decreases to 1,100,000 people in 2035. The pace of 1000000 20 decrease in the small scale local governments such 800000 Aging rate(％) Aging Population 15 as Kminoseki-cho,Abu-cho, Atou-cho, Suo 600000 10 400000 Ooshima-cho is high. On the other hand, as for the 200000 5 old people (over 65 years old) population, it is on 0 0 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 the increase from 210,000 people in 1985, and it Census execution fiscal year Institute of Population Problems dt Total population Over 65 years old population reaches 460,000 people in 2020, it shifts to the Over 75 years old population Over 65 years old aging rate Over 75 years old aging rate decrease after that, and it is predicted that it Fig.3 decreases gradually. It is predicted that population Total population, old people population and aging rate decreases over 75 years from 2025, so the increase change tendency of aging rate becomes weak, but the aging 0.800 rate (over 65 years old) will meet 37% in 2035 by 1995-2005 0.600 the decrease in total population. 1985-1995 0.400 1985-1995 2.2 THE POPULATION CHANGE PATTERN 1995-2005 0.200 2035 2005-2015 2035 2025 BY THE INDEX OF POPULATION, 0.000 2015 2015 2025 2005 -1.500factor first The -1.000 -0.500 0.000 0.500 1.000 1.500 2005 AGING RATE 2005-2015 2015-2025 2025-2035 1995 2015-1035-0.200 2025-2035 To grasp the characteristics of change of old 2005-2015 1985 2015-1025 2005-2015 1995 1995-2005-0.400 2025-2035 people population of every local government in 1985 Yamaguchi Prefecture, the factor analysis was done -0.600 The first factor by the indexes of the total population increase and Total population increase and decrease rate Over 65 years old population increase and decrease rate Over 75 years old population increase and decrease rate decrease rate in every 10 from 1985 to 2035, over Over 65 years old aging rate Over 75 years old aging rate 65 years old population increase and decrease rate, Total population in 1985 over 75 years old population increase and decrease Fig.4 The factor score distribution of first and rate, over 65 and 75 years old aging rate in every 5 second shaft Ⅱ from 1985 to 2035, and total population in 25.000 The town type 1985.The analysis is proceeded by using the first 20.000 Kaminoseki Suo-Oosima 15.000 and second factor which the characteristic value of The middle type Abu 10.000 the factor is effective. Ato Hirao Yanai Nagato The city type The factor score distribution of first and 5.000 Iwakuni Tabuse 0.000 Ⅰ second shaft is shown in the figure 4, and the factor -100.00 -80.000 -60.000 -40.000 -20.000 0.000 20.000 40.000 60.000 HagiMine Yamaguchi The second factor second The 0 -5.000 Shuunan Waki score distribution of local governments is shown in Shimonoseki Ube -10.000 Onoda Houhu the figure 5.