Comparative Study on the Administration and Finance of the Care Security Systems: Japan and European Counties

我们的研究项目旨在发现护理保障系统的重组。为此，我们考察了欧洲国家的医疗保险制度，并与我国的医疗保险制度进行了比较。我们的研究框架的要点如下：(1)适合用户/居住者需求的护理服务体系。(2)护理服务的组织，包括护理管理(3)护理相关人员的培训体系。(4)使用者的索赔和救济制度。(5)实现上述制度的筹资和管理制度。我国的公共长期护理保险制度启动。从2000年4月开始，社会保险形式是社会保险；然而，超过一半的资金来自税收。因此，我们把重点放在了德国和瑞典的研究目标上。在瑞典，到20世纪80年代，地方政府形成了全民保健制度，包括社会家庭帮助和老年人住房/设施。在20世纪90年代经济危机的影响下，瑞典的护理体系进行了重组，改用其他体系：权力下放和在社会护理中引入市场机制。然而，他们试图继续保持护理服务的质量，改革护理管理者的培训制度，实现服务的有效性和服务组织的效率。在德国，我们也得到了关于社会长期护理保险下护理人员培训制度和标准的重组信息。我们的研究结果是服务有效性的重要性：培训制度、护理人员标准、服务组织和替代制度，以使服务高质量，此外，还应为使用者/居民建立服务资格标准和索赔救济制度。

Our research project aimed to discover the reorganization of the Care Security Systems. To do this task, we investigated the Care Systems of European counties and compared with that of our country. The points of our research frameworks are as follows.(1) Care service systems fitting needs of users/inhabjtants.(2) Organization of care delivery services, including care management(3) Training System for care related worker.(4) Claim and relief systems of the users.(5) Financing and administrative systems to attain the systems mentioned above.Public long-term care insurance systems in our country, started.from April 2000, are social insurance in form ; however, more than half money is financed by tax. So, we focused those of Germany and Sweden to do our research aims. In Sweden, local governments formed universal Care Systems including social home help and house/facilities for the elderly by 1980s. Under the economic crisis in 1990s, Swedish care systems had been reorganized to alternative ones; decentralization and the introducing market mechanism in social care. However, they try to continue the quality of care services, reforming training system of care manager; to realize effectiveness of services and efficiency of service organization. In Germany, we also got information about the reorganization of the training systems and standard of care staffs, under the social long-term care insurance.The result of our research as to theme is the importance of effectiveness of services: training systems, standard of cares workers, service organization and alternative systems to make services high quality, In addition, eligibility criteria of services and the claim-relief systems should be established for the user/inhabitants.