An attendant uses a tablet computer on a SoftBank Group Corp.'s Pepper humanoid robot at the Robodex Trade Show, Tokyo, Japan, 2017

The Impact of Robots on Nursing Home Care in Japan

Exploring the implications of robotic technologies adoption in aging societies

Robot strategy for an aging world

How will increasing robot utilization interact with societies that face the challenges of declining and aging populations? Japan’s case sheds light on the social and economic implications of robotic technologies adoption for addressing demographic change. In one of the first research projects globally to examine the impact of robotics in the service sector, APARC researchers identify how robots affect labor and productivity in Japan’s nursing homes.

Research Focus

Japan has been a leader in robot production and utilization for many years, and is now looking to use robots to cope with its changing demographics. Rapid population aging and the shortage of caregivers have spurred the government to promote the use of robots in nursing homes. As part of its robot strategy, the government began to provide robot subsidies to nursing homes in 2015. Already by 2016, about 15% of the country’s nursing homes had adopted robots, but it is not yet known whether use of robots has become more widespread since then and contributed to greater efficiency and/or better quality of care.
 
The Impact of Robots on Nursing Home Care in Japan research project compares and contrasts adoption of robots in long-term care, and aims to provide better understanding of its potential impacts on productivity, labor markets, and quality of care. It explores questions including how the adoption of robots affect labor inputs and the quality of care (patient outcomes) in nursing homes, and whether there are complementarities between robots, management, and specific types of labor or skills.
 
To examine nurse staffing and quality of care, the researchers will use both survey data and administrative data from the universe of nursing homes in Japan in the Japanese government dataset, Kaigokensaku, which provides basic data on the universe of care facilities. This data set, however, does not include detailed information about robot adoption and use. To provide this missing information, the researchers will conduct a survey collecting nursing-home-level data on robot adoption (the types of robot, cost, and utilization), staffing (number and types of nurses, nurse hours, other personnel inputs), and information commonly used to assess quality of care (such as pressure ulcer rate, persistent pain rate, etc., partially based on measures the long-term-care insurance program uses to monitor and reward providers). They will randomize among the universe of all nursing homes based on the Kaigokensaku sample frame. This sampling strategy will address the selection bias that often arises in empirical analyses. 
 
The researchers have already created a comprehensive list of subsidy amounts, eligibility criteria, and types of subsidized robots across all prefectures in Japan, as well as the largest municipalities in each prefecture (which often offer additional subsidies to nursing homes). The will use the variation in robot subsidies across prefectures and municipalities over time to examine robot adoption, and how robots impact staffing and the quality of care. With the unique quasi-experimental setting along with detailed administrative data and survey data, this research project will identify how robots affect labor and productivity in nursing homes. This is one of the first research projects globally to examine the impact of robotics in the service sector at the establishment level. 

Lead Researchers and Collaborators

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Karen Eggleston

APARC Deputy Director and Asia Health Policy Program Director
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Karen Eggleston

APARC Deputy Director and Asia Health Policy Program Director
Senior Fellow, Freeman Spogli Institute for International Studies
Fellow at the Center for Health Policy and the Center for Primary Care and Outcomes Research
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Yong Suk Lee

Shorenstein APARC Korea Program Deputy Director
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Yong Suk Lee

Shorenstein APARC Korea Program Deputy Director
SK Center Fellow, Freeman Spogli Institute for International Studies
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Toshiaki Iizuka

Professor at the Graduate School of Public Policy and Graduate School of Economics, University of Tokyo
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Toshiaki Iizuka

Professor at the Graduate School of Public Policy and Graduate School of Economics, University of Tokyo
2018-19 Visiting Scholar, Asia Health Policy Program at APARC