Japan's experience in long-term home health care of the elderly.

Due to increasing national health expenditure and an aging society, Japan in the 1980s started to reinforce home health care, going beyond her long-time investment in institutional care. Since 1983, a sequence of policies was issued focused mainly on frail elderly care. In support of this governmental approach, a variety of enterprises and charity activities have flourished. Now, however, in the midst of a worldwide recession, rationing as health policy is under reconsideration and has an influence on health care for minorities, including the elderly. In Japan, home health care is under review and a new service system was initiated in April 1992. In this article, the newly inaugurated community-based home visiting nursing scheme is introduced together with a short history of elderly care and related business activities in Japan. Feasibility of the new scheme is discussed and compared with the previous version of home visiting nursing, which had its base in hospitals.