The pension sys tem and the housing allowance system are different in the two countries, so it is difficult to say which expenses by the resident self is cheaper.  

　I think that the Swedish researchers wonder How Japanese can take care of elderly so "effectively"?  But it is not effective.  As a result, many residents in Japanese institutions can not get enough activation and rehabilitation.  The care stuffs have no time to take the residents to the toilets and the dining rooms. So many residents at Japanese institutions are forced to live on the bed every day and wear diapers.

   And at some hospitals, bedridden or senile dementia patients must employ private care stuffs by themselves, because the number of care stuffs is too low.  In such case, patients must pay 400-800 SEK per day.

   The ratio between the elderly patients and the stuffs at the geriatric hospitals is about 1:0.33.  In spite of the fact that there are not a few "Medically Ready Treated" patients at the Japanese geriatric hospitals, but this ratio l:0.33 is too low.  As a result, there is very little rehabilitation and activity and let patients lie on the beds whole day every day.  It produces more and more the "Bedridden Elderly".  Not only at the geriatric hospitals , but a I so at the genera I hospitals in Japan , the numbers of physicians and nurses are very low compared to the international standard.

 Figure.12 , Numbers of Physicians & Nurses (per 100 beds)

Rcprinted from Y.Sugaya "Nihon No Iryo to Obei No Iryo No Hikaku by Dr.Sugaya's and Hcalth and Welfare Statistics Association

  Table . 18 shows the percentage of the "Bedridden Elderly" at the long-term care institutions in different countries.

  This survey was done by the Japanese Ministry of Health and Welfare in 1988. The definition of the "Bedridden" is that the patients who spend most of their daily time on their beds. 

"Long-Term Care Facilities" means nursing home and geriatric hospital in Japan.

  The reason why there are so many bedridden (bed-bound) patients
at the long term facilities in Japan is as follows.

   Many of the bedridden patients in Japan can ride on the wheel chair by the assist of the care stuffs also.  But the lack of the number of stuffs (as I mentioned by Table.16) force them to stay on the beds all the time.  At the experiment at the Oume Keiyu Geriatric Hospital in Japan, more than 90% of the "bedridden" patients became to be able to walk by the assist of the stuffs. 
( "Netakiri Zero wo Mezashlte" by the Japanese Ministry of Health and welfare in 1988).

   Another problem is the low quality of life: at the geriatric hospital.  About 4-20 elderly patients share the one room and  there is no dining room.  It means that they live and eat on the beds every day.  The space for the one patient at the Japanese geriatric hospital is minimum (usually this is the standard) 8 m2.  Moreover there is only one toilette in one ward (about 30-50 patients) .  And the care-stuffs are so busy and have no time to guide the patients to the toilets.  It means that if the patients can not walk to the toilette , they must wear baby-pants.  Sometimes they put portable toilets beside the bed but this way is problem from the standpoint of the privacy.  

As I have explained, the geriatric hospitals have so serious problems, but majority of the elderly and their families prefer the geriatric hospitals to the nursing homes for the aged.

The biggest reason is the prejudice. In the past nursing homes for the aged was called "poor house" (fattig vård) in Japan. But the geriatric hospitals do not have such kind of prejudice. Another reason is that there is a very long waiting list for the nursing homes. Usually they must wait about one or two years to succeed to stay at the nursing homes but they can move to the geriatric hospitals much more quickly and easily.   Every month the district social welfare committee discuss and decide who can move to the nursing homes.   But the hospitals can decide by themselves who can move to the geriatric hospitals.   Another problem is that for the rich elderly, it is more expensive to stay at the nursing homes than at the geriatric hospitals.  The ~monthly fees charged by the nursing homes are income-related and is maximum 250.000 YEN (16,600 SEK) - average 25,000 YEN(1,660 SEK).  But the fees for the geriatric hospitals are not income-related and is roughly around 100,000 YEN(6,600 SEK).   So rich elderly and their families prefer geriatric hospitals. But the average social cost is on the contrary.   Government pays about 250,000 YEN(16,600 SEK) per one patient per one month for the nursing homes and average about 400,000 YEN (26,600 SEK) per one patient per one month for the geriatric hospitals.