Business continuity planning (BCP) ensures that critical healthcare operations are not interrupted and are recovered quickly, in the event of a disaster. BCP has an important role in avoiding adverse health impacts, particularly in long-term care settings. The purpose of this study is to conduct a literature review and comparison of the U.S. and Japanese BCP in long-term care to identify and compare challenges and desirable approaches in each country to support older adults.

We systematically searched PubMed, CINAHL, Japan Medical Abstracts Society and EMBASE databases, gray literature, and conducted a hand search of high-impact journals for studies published between 2000 and 2022 that assessed BCP in the United States and Japan.

From the literature, a challenge identified in the U.S. is the limited coordination within and across regions and between healthcare institutions and long-term care settings. The advantages are that an established structure of planning, training and evaluation is in place, with evidence from recent disasters showing net positive effects. In Japan, a significant challenge is that, despite an emphasis on continuity in the provision of medical care and welfare to individuals, cooperation between BCP at healthcare institutions and BCP at long-term care facilities is underdeveloped. The advantage is that BCP at medical institutions is incorporated into the national healthcare plan in Japan, making it easy to design BCP protocols and plans according to local needs.

Future research should focus on two points. 1) In the U.S., there is a need for evaluation of BCP cooperation and coordination among healthcare networks, especially in long-term care settings. 2) In Japan, it is necessary to promote BCP in healthcare sectors and accumulate training and evaluation across the fields of medical institutions and long-term care facilities.