Introduction The government of Japan encourages municipalities to promote Health Services for Disability Prevention (HSDP) to contain the increasing trend of Long-term Care Insurance (LTCI) expenditure for the care of aged people with disability. Although the proportion of the budget expenditure for HSDP varies among municipalities, it has been unclear whether these differences are related to the containment of LTCI expenditure. The objective of this study was to examine whether there is some relationship between the proportions of budget expenditure for HSDP and LTCI in all of the municipalities in Japan.

Methods 1640 municipalities were categorised into five groups according to the mean budget expenditure for HSDP per resident aged ≥65 years in 2006–2008 (<£5, £5–<£7, £7–<£9, £9–<£11, ≥£11). The rate of increase (%) in LTCI expenditure from 2006 to 2008 was calculated in each category. One-way analysis of variance was used.

Results The rate of increase in LTCI expenditure differed significantly between expenditure categories for HSDP (120.7 %, 120.4 %, 119.0 %, 118.5 %, 117.0 % from the lowest group [<£5] to the highest group [≥£11] respectively; p<0.001). These differences were mainly attributable to significant inverse correlation between budget expenditure for HSDP and the rate of increase in fraction of those who use formal care under LTCI.

Conclusion Municipalities with higher budget expenditure for HSDP have a lower rate of increase in LTCI expenditure, suggesting that HSDP would be a cost-effective service.