長距離ちょうきょり移動いどうが負担ふたんに “地域ちいきの実情じつじょうに合あった報酬ほうしゅう体系たいけいを”

In 15 years, in 2040,

<br>It is estimated that there are 39.28 million elderly people aged 65 and over, accounting for more than 30% of the population.

<br>However, the demand for nursing care services has already started to decline in mountainous areas and depopulated regions

<br>The Ministry of Health, Labour and Welfares review panel has compiled a proposal that such regions should consider introducing a new remuneration system.

<br>There are days when travel exceeds 100 kilometers Increased burden due to decreased users<br>We covered one of the areas where it is becoming difficult to maintain services such as home care.

<br><br>This is Yoshika Town in Shimane Prefecture, located in a mountainous area and experiencing population decline.

With a population of approximately 5,500 and an aging rate of over 46%, one in three residents is a late-stage elderly person aged 75 or older, and the only organization providing home care services in the town is the Social Welfare Council.

Eight staff members work here, and there are currently 58 elderly users, which is about 20 fewer than five years ago.

<br><br>Because users homes are scattered in mountainous areas, travel distances can exceed 100 kilometers per person, allowing for a maximum of about 15 visits per day across the entire office.

On this day, a home helper visited the home of an 84-year-old woman living in an area more than 20 kilometers away by car, which took about 30 minutes.

<br><br>The woman has aftereffects on her leg due to a cerebral infarction and receives bathing assistance from a home helper twice a week.

<br><br>The woman lives with her elderly husband, and she mentioned that without services, it would be difficult to continue living in this area where they have been accustomed to living for many years.

<br><br>The costs such as travel time and gasoline expenses are covered by the income from home care service fees, so if a cancellation notice is suddenly received while traveling, the compensation becomes zero and it becomes a burden on the service provider.

<br><br>Last years gasoline cost was approximately 900,000 yen by February, and although the number of users is decreasing, the travel distance remains the same, so the burden of travel is said to be increasing year by year.

<br><br>The reduction in the basic remuneration for home-visit care in last years national remuneration revision has also had an impact, resulting in an annual deficit of 250,000 yen for the home-visit care business at this office as of the end of February.

<br><br>The shortage of workers is also severe, with 4 staff members and 4 part-time employees working at the office, but their average age is 56

<br><br>They say that even if they advertise for recruitment, there are no applicants, making it difficult to maintain the service.

<br><br>Chitose Maekawa, Director of Yoshika Town Social Welfare Council Yoshika Town Home Helper Station<br> I believe its an indispensable service as we are the only home care service in town, but weve been running at a deficit.

We want the government to consider a reward system that takes into account the realities of mountainous areas, which are different from urban areas, such as the time it takes to travel. <br> The number of bankruptcies and closures of home-visit care offices reached a record high of 529 cases since the survey began. <br> According to a private credit research company, Tokyo Shoko Research, the number of bankruptcies and closures of home-visit care offices last year was 529, an increase of more than 100 from the previous year, the highest since the survey began in 2010.

Since the beginning of this year, the number of bankruptcies of home-visit care businesses by the end of March is 22 cases, which is progressing at a pace exceeding the same period last year.

Tokyo Shoko Research suggests that factors contributing to the bankruptcy include the reduction in basic fees for home-visit care last year and a shortage of home helpers.

<br>A reward system that considers travel time and costs was proposed at a Ministry of Health, Labor and Welfare study group<br>Yesterday, a study group of the Ministry of Health, Labor and Welfare was held to consider the provision system for home visit services such as nursing care toward 2040. It was pointed out that in areas where demand has decreased, the distance traveled for home visits has increased due to the decrease in both users and service providers.

Currently, the fee structure for home-visit care is calculated based on the number of visits, and the time and cost involved in traveling are not reflected in the fees.

In the study group on this current situation, a proposal was compiled suggesting that for mountainous areas and depopulated regions, a comprehensive evaluation system that takes into account travel time and costs according to local needs should be considered, in addition to the current nationwide uniform standards for calculating remuneration.

<br><br>The Ministry of Health, Labour and Welfare plans to report the current proposal to a council of experts and discuss necessary legal amendments.

<br>Expert: Discussion needed to secure economic foundation of businesses<br>Professor Yasuhiro Yuki of Shukutoku University, who is knowledgeable about caregiving issues, commented on services in mountainous and depopulated areas, saying, It is not uncommon for home care service providers to refuse visits to elderly people living far away due to tight management and unprofitability, or to visit them despite expecting a deficit.

There are municipalities without a single home care service provider, and elderly residents in such areas are increasingly unable to receive services despite paying long-term care insurance premiums, he points out.

In addition, this time, a proposal was presented regarding the reward system that takes into account the burden of travel in mountainous and depopulated areas, stating that although nursing care fees are evaluated based on the unit price of services provided, the biggest issue in mountainous areas is that travel takes time and is inefficient, and the point that this must be properly addressed is commendable.

In order to provide sufficient nursing care services, discussions must ensure that the financial strength of businesses in mountainous areas is solidified using rewards and subsidies. Therefore, discussions should be advanced to secure an economic foundation that allows businesses to cope with the costs of transportation, they said.