Direct and indirect costs of home healthcare in Japan: A cross-sectional study

Shiori Tomita, Eri Hoshino, Keisuke Kamiya, Osugi Yasuhiro, Mahbubur Rahman

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)1109-1117
Number of pages9
JournalHealth and Social Care in the Community
Issue number3
Publication statusPublished - 01-05-2020

All Science Journal Classification (ASJC) codes

  • Social Sciences (miscellaneous)
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health


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