「2025年に向けた新しい地域づくり　－地域包括ケアシステムの構築を目指して－」

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1 2025 integrated care

2 National institute of Public Health, Japan 2

3 1. National institute of Public Health, Japan 3

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7 Three levels of care: principle p of subsidiarity Self Help Mutual Help Public Assistance Self care: individual Not systematized Mutual care: Informal network base on locality or co-belongingness (Fürsorge) Social solidarity care: Social solidarity based on same goal Association Govermental care: Government systematized The Japanese system stem and the four levels els in the provision of care T. Tsutsui, T. Matushige,M Otaga,M Morikawa. From care by family to care by society and care in local communities : switching to a small government by the shift of long-term care provision. ISA world congress of Sociology,Gothenburg, Sweden July 2010 paper 7

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9 Three paradigm phases in Japanese long-term care Phase 1 : care by family ( -1999) Informal network inside the community or co- belongingness or Fürsorge (by Community) Phase 2 : care by society ( ) Social Solidarity based on a same goal by Association Mutual Help: Mutual Help: Social solidarity care: Phase 3 : care by community ( ) SYSTEMATISED Informal network inside the community or co-belongingness or Fürsorge (in the Community) Mutual Help: Systematizing mutual help ( ) T. Tsutsui, T. Matushige,M Otaga,M Morikawa. From care by family to care by society and care in local communities : switching to a small government by the shift of long-term care provision. ISA world congress of Sociology,Gothenburg, Sweden July 2010 discussion paper Social solidarity care: System of Mutual care 9

10 T. Takako, S. Higashino, M. Otaga.Changes in the Filial Obligations of Family Caregivers under the Public Long-Term Care Insurance System in Japan.the 19th IAGG World Congress, p.298, paris,france, July 5-9,

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12 % % , ,000 11, ,000 ISA world congress of Sociology,Seoul, Korea 2013.[symposium] Promoting Access, Quality and Cost Containment in Japan s Long Term Care System: Current Policies and Future Directions. Thomas Klie

13 50 ISA world congress of Sociology,Seoul, Korea 2013.[symposium] Promoting Access, Quality and Cost Containment in Japan s Long Term Care System: Current Policies and Future Directions. Thomas Klie

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15 Community based careintegrated care Community-based care Community-based care Integrated care Integrated t care care 1 T. Plochg NS. Klanzinga Community-based integrated care: myth or must? International Journal for Quality in Health Care 14:91-101: T. Plochg Building a Tower of Babel in health care? Theory & practice of community-based integrated care International Journal of Integrated Care. 6 e

16 Integrated care Bodenheimer T. Coordinating Care -- A Perilous Journey through the Health Care System. New England Journal of Medicine 2008 March 6;358(10): Pham HH, Schrag D, O'Malley AS, Wu B, Bach PB. Care patterns in Medicare and their implications for pay for performance. New England Journal of Medicine 2007 March 15;356(11):

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18 Integrated care 4 NPO, Vaarama, M., Pieper, R.(eds.) (2006). Managing integrated care for older people. STAKES, Helshinki. Somme, D., Trouvé, H. (2009). Implanter et évaluer une politique d'intégration des services aux personnes âgées: l expérimentation PRISMA France. In L évaluation des , L'Harmattan, Paris. Couturier, Y., Trouvé, H., Ganon, D., Etheridge, F., Carrire, S.& Somme, D. (2009). Réceptivité d'un modèle québécois d'intégration des services aux personnes âgées en perte d'autonomie en France. Lien social et politiques, n.62 Henrard, JC. (2002). Le système français d aide et de soins aux personnes âgées. Santé Société et Solidarité, 2:

19 integrated care WHO ECintegrated care 2010Integrated careintegrated care Goodwin, N. (2010) Integrated care as a scientific discipline: the need for more theory and new analytical methods, International Journal of Integrated Care, Vol

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21 2. National institute of Public Health, Japan 21

22 Integrated care 9 Integrated care ** ** * Integrated care *** ** * Leinchsering K.(2004). Developing integrated health and social care services for older persons in Europe. International Journal of Integrated Care, Vol.4, e01-e15 22

23 3 Banks,2004;Kodner and Kyriacou,

24 vertical integration horizontal integration C B A 95 Health Maintenance Organization(HMOs) HMO 24

25 Integration Leutz(1999) Integration Linkage Coordination Full integration Linkage Coordination CoodinationLinkage Integration Full integration 25

26 Linkage Coordination Full integration, Margaret MacAdam. Frameworks of Integrated Care for the Elderly: A Systematic Review Canadian Policy Research Networks Inc 26

27 Suter integrated care Suter, E., Oelke,ND., Adair, CE., Armitage, GD. (2010). Ten Key Principles for Successful Health Systems Integration Healthc Q October; 13(Spec No):

28 ICP Integrated Care Pilots RAND Europe (2012).National Evaluation of the Department of Health s Integrated Care Pilots FINAL REPORT: FULL VERSION 28

29 Integrated care Margaret MacAdam. Frameworks of Integrated Care for the Elderly: A Systematic Review Canadian Policy Research Networks Inc 29

30 捗捗 P84-151

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36 Integrated care 4 NPO, Vaarama, M., Pieper, R.(eds.) (2006). Managing integrated care for older people. STAKES, Helshinki. Somme, D., Trouvé, H. (2009). Implanter et évaluer une politique d'intégration des services aux personnes âgées: l expérimentation PRISMA France. In L évaluation des , L'Harmattan, Paris. Couturier, Y., Trouvé, H., Ganon, D., Etheridge, F., Carrire, S.& Somme, D. (2009). Réceptivité d'un modèle québécois d'intégration des services aux personnes âgées en perte d'autonomie en France. Lien social et politiques, n.62 Henrard, JC. (2002). Le système français d aide et de soins aux personnes âgées. Santé Société et Solidarité, 2:

37 integrated care system

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<95DB8C9288E397C389C88A E696E6462> 2011 Vol.60 No.2 p.138 147 Performance of the Japanese long-term care benefit: An International comparison based on OECD health data Mie MORIKAWA[1] Takako TSUTSUI[2] [1]National Institute of Public Health,

「2025年に向けた新しい地域づくり －地域包括ケアシステムの構築を目指して－」

「2025年に向けた新しい地域づくり　－地域包括ケアシステムの構築を目指して－」