The health and social system for the aged in Japan
The health and social system for the aged in Japan
复制标题
日本的老年人健康和社会制度
DOI：
10.1007/bf03324449
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发表时间：
2002
影响因子：
4
通讯作者：
S. Matsuda
中科院分区：
文献类型：
--
作者：
S. Matsuda
2000年4月1日，日本实施了一项新的针对体弱者和老年人的社会保险计划--长期护理保险(LTCI)。这在日本公共卫生政策的历史上是一个颇具代表性的事件，因为它意味着日本改变了家庭照顾老年人的传统，走向了照顾的社会化。成立LTCI背后的主要想法之一是使老年人的护理去医疗化和合理化，这是老龄化过程的特点。由于社会老龄化，日本的社会保险制度需要进行根本性的改革。LTCI的实施是日本未来医疗改革的第一步。LTCI计划要求每个公民在社会保障体系中承担更多的财务和决策责任。LTCI的引入也给日本卫生系统带来了根本性的结构性变化。随着综合交付系统的发展，诸如辅助生活等替代护理服务正在进行中。另一个重要的社会变化是社区健康长寿运动。例如，为了让老年人尽可能地保持健康和活跃，组织了各种公共卫生和社会计划。在这篇文章中，作者解释了日本卫生系统正在进行的结构变化。重点分析了目前关于重组日本老年人健康保险计划和为老年人提供社区公共卫生服务的辩论。
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.