2025 Volume 20 Issue 1 Pages 92-113
This study elucidates the state of a community-based integrated care system established through intermunicipal collaboration, particularly among small municipalities in rural areas. It examines the vertical and horizontal linkages connecting entities within this system, built through multilevel governance. The analysis reveals that in the Chichibu area, vertical and horizontal linkages among entities being formed at the municipal and above the intermunicipal level of collaboration, respectively. The system was also constructed through the construction and vertical linkage of networks on both levels. Multi-level governance points to a lack of coordination between these levels. However, in the case of the Chichibu area, the aforementioned point is not applicable as long as the meta-governance authority of various institutions in the medical and welfare sectors of Chichibu City is within its designated scope of authority. This establishment of cooperation between the two levels differs from the case of the Uwajima area in Ehime Prefecture. Therefore, this raises a future issue regarding the appropriate level at which the meta-governor should be positioned in multilevel governance.
