Abstract
It is very common that a frail aged has multiple social and medical needs. A fragmented service delivery system is not adequate to respond to the needs of such a frail aged. It requires an integrated care service. In order to realize an integrated health services for the aged, the Japanese government has implemented the care management system into the Long Term Care Insurance Scheme in 2000. Traditionally physicians have played a key role in the authority and have influenced the care process of the frail elderly. However, the introduction of care management system under LTCI has changed the balance of authority from the physician to the care manager. Although this authority shift has not been fully accepted, this change will be an important step for the realization of integrated care delivery scheme in Japan.
