『保健医療科学』 2024 第73巻 第1号 p.32-41（2024年2月）
Topics：Recent topics in public health in Japan 2024
＜Review＞
Community-based inclusive society and integrated care in Japan:
Concepts and challenges for practice
OTAGA Masaaki
Department of Health and Welfare Services, National Institute of Public Health
Abstract
Since the 1990s, the concept of integrated care has been used to examine methods of care delivery that ensure quality while increasing efficiency. Japan has developed a service-delivery system that specializes in independent long-term care through universal public long-term care insurance to respond to the growing care needs of its aging population. This caused a fragmentation of medical care, rehabilitation, and other welfare services, and the concept of community-based integrated care was proposed as an attempt to integrate these services. As the development of the welfare system for older adults was followed by the development of support for various target groups such as the needy, children and families, and people with disabilities, the concept of community-inclusive society was proposed in the context of the need to overcome the vertical system that characterized the welfare system in Japan. This concept of community-based inclusive society can be explained as including the Japanese concept of integrated care, in which community-based integrated care is provided regardless of the target population, and the concept of community building, which is promoted through collaboration between “supporters and receivers of care” or “people and communities”. Efforts to build an integrated support system to achieve community-based inclusive society have been a policy initiative since FY2016, and the Multilayered Support System Improvement Project by the municipality has just begun in FY2021. In order to facilitate the building of this system, the project is expected to identify ways to develop strategies and initiatives in the project that reflect historical, cultural, and social factors in the region.
keywords: community-based inclusive society, community-based integrated care, integrated care, integrated support system, Multi-Layered Support System Improvement Project
Community-based inclusive society and integrated care in Japan: Concepts and challenges for practice