The health and social system for the aged in Japan
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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 WordsCare management community services disabled elderly home care integrated delivery system Japan long-term care insurance systems of care
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- 1.Andersson G, Karlberg I. Integrated care for the elderly. The background and effects of the reform of Swedish care of the elderly. International Journal of Integrated Care 2000; 1.Google Scholar
- 2.Matsuda S, Okochi J, Takahashi T, Takamuku K. Problems regarding the patient classification system in the long-term care insurance of the aged in Japan. Casemix Quarterly 2001; 3: 15–22.Google Scholar
- 3.Shakai Hoken Junpo (A ten days report on social security). 2001; No.2004: 32–33 (in Japanese).Google Scholar
- 4.Matsuda S. Study on estimation of the necessary volume of home care services for the frail elderly in the community. Kitakyushu: UOEH, 2000 (in Japanese).Google Scholar
- 5.ILO. 1998–1999 edition of Yearbook of Labor Statistics (Japan). Tokyo: ILO, 2000.Google Scholar
- 6.Niki R. Hoken-Iryo-Fukusi Fukugotai (Integrated Delivery System). Tokyo: Igaku shoin, 1998 (in Japanese).Google Scholar
- 7.Matsuda S. The Report on Integrated Delivery System. Tokyo: Saiseikai, 1999 (in Japanese).Google Scholar
- 8.Matsuda S. The First Report on Integrated Delivery System in Japan. Tokyo: Institute for Health Economics and Policy, 1999 (in Japanese).Google Scholar
- 9.Matsuda S. The Second Report on Integrated Delivery System in Japan. Tokyo: Institute for Health Economics and Policy, 2000 (in Japanese).Google Scholar