Towards community-based integrated care: trends and issues in Japan's long-term care policy.
Towards community-based integrated care: trends and issues in Japan's long-term care policy.
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DOI：
10.5334/ijic.1066
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发表时间：
2014-01
影响因子：
2.4
通讯作者：
Morikawa M
中科院分区：
文献类型：
--
作者：
Morikawa M
2000年，日本实行强制性长期护理保险制度。随着系统的快速发展，问题也逐渐显现出来。对长期护理保险制度进行了几项重大改革，特别是在综合护理方面。本文阐明了导致长期护理保险制度改革的政策趋势，其中包括“综合护理”和“社区护理”的新概念、成本控制和服务精简议程以及与医疗保健的协调。正如长期护理政策所设想的，基于社区的综合护理不仅包括将医疗护理纳入服务提供，还包括非正式互助、政府对营利性提供者的监督以确保用户不被剥削以及覆盖不同地理区域的系统之间的协调。日本在社区护理整合方面的经验表明，该项目需要在当地社区进行多方面的护理整合。未来有必要对这些措施的有效性进行实证评估。
In 2000, Japan implemented a mandatory long-term care insurance system. With the rapid growth of the system, problems became apparent. Several critical alterations were made to long-term care insurance system, particularly with respect to integrated care. This paper elucidates the policy trends that led to the reforms of the long-term care insurance system, which included new concepts of ‘integrated care’ and ‘community-based care’, an agenda of cost containment and service streamlining, and coordination with medical care. Community-based integrated care, as envisaged in the long-term care policy, includes not only the integration of medical care into service provision but also the inclusion of the informal mutual aid, oversight of for-profit providers by an administration that ensures users are not exploited and coordination between systems that cover different geographical areas. Japan's experience in community-based care integration suggests that this project requires multi-faceted care integration in local communities. In the future, it will be necessary to conduct empirical assessments of the effectiveness of these measures.