Aging Clinical and Experimental Research

, Volume 14, Issue 4, pp 265–270 | Cite as

The health and social system for the aged in Japan

  • Shinya MatsudaEmail author
Systems of Care in Selected Countries


Japan implemented a new social insurance scheme for the frail and elderly, Long-Term-Care Insurance (LTCI) on 1 April 2000. This was an époque-making event in the history of the Japanese public health policy, because it meant that in modifying its tradition of family care for the elderly, Japan had moved toward socialization of care. One of the main ideas behind the establishment of LTCI was to “de-medicalize” and rationalize the care of elderly persons with disabilities characteristic of the aging process. Because of the aging of the society, the Japanese social insurance system required a fundamental reform. The implementation of LTCI constitutes the first step in the future health reform in Japan. The LTCI scheme requires each citizen to take more responsibility for finance and decision-making in the social security system. The introduction of LTCI is also bringing in fundamental structural changes in the Japanese health system. With the development of the Integrated Delivery System (IDS), alternative care services such as assisted living are on-going. Another important social change is a community movement for the healthy longevity. For example, a variety of public health and social programs are organized in order to keep the elderly healthy and active as long as possible. In this article, the author explains on-going structural changes in the Japanese health system. Analyses are focused on the current debate for the reorganization of the health insurance scheme for the aged in Japan and community public health services for them.

Key Words

Care management community services disabled elderly home care integrated delivery system Japan long-term care insurance systems of care 


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Copyright information

© Springer Internal Publishing Switzerland 2002

Authors and Affiliations

  1. 1.Department of Preventive Medicine and Community HealthUniversity of Occupational and Environmental HealthYahatanishi-ku, KitakyushuJapan

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