Abstract
Introduction:Japan has the largest percentage of elderly people in the world. In 2012 the government implemented a community-based integrated care system which provides seamless community healthcare resources for elderly people with chronic diseases and disabilities.Methods:This paper describes the challenges of establishing a community-based integrated care system in 1974 in Mitsugi, a rural town of Japan. This system has influenced the government and become the model for the nationwide system.Results:In the 1970s, Mitsugi’s aging population was growing faster than Japan’s, but elder care was fragmented among a variety of service sections. A community-based integrated care system evolved because of the small but aging population size and the initiative of some local leaders of medical care and politics. After the system took effect, the proportion of bedridden people and medical care costs for the elderly dropped in Mitsugi while it continued to rise everywhere else in Japan. Mitsugi’s community-based integrated care system is now shaping national policy.Conclusion:Mitsugi is in the vanguard of Japan’s community-based integrated care system. The case showed the community-based integrated care system can diffuse from rural to urban areas.
Highlights
Japan has the largest percentage of elderly people in the world
Its roles and function were moved to the Community-based Integrated Care Center in the Health and Welfare Center in 2006, when the government revised the Long-term Care Insurance Act
The government hopes that the system will be in place nationwide by 2025 when Japan’s population of older people is expected to reach its peak [21]
Summary
To coordinate the increasing number of functions of the hospital complex for elderly care, the Home-based Long-term Care Support Center opened in 1990 in the geriatric health service facility, the predecessor of the Community-based Integrated Care Centers that are found all over Japan. Its roles and function were moved to the Community-based Integrated Care Center in the Health and Welfare Center in 2006, when the government revised the Long-term Care Insurance Act. The special nursing home and the rehabilitation centre was opened in 1981, the geriatric health service facility in 1989, the care house in 1993 and the group home for elderly patients with dementia in 2002. The government hopes that the system will be in place nationwide by 2025 when Japan’s population of older people is expected to reach its peak [21]
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