Abstract
Pension and medical insurance schemes were operated in Japan since before World War II, but some people in the informal sector were not covered. Amid rapid economic growth after the war, the government sought to solve this problem, and universal insurance coverage was introduced in 1961. Japan's history after the introduction of universal insurance coverage overlaps with the history of aging countermeasures.
The government has been continuing its efforts to integrate care to meet the needs of a super-aged society and to strengthen primary care and community medicine, enacting the Re-arrangement of Relevant Acts for Promoting the Comprehensive Provision of Medical and Nursing Care in Communities in 2014. This act promotes the building of community-level comprehensive support and service setups (which is to say community-level comprehensive care systems) so that, as far as possible, people can continue to live in their own way and in familiar surroundings until the end of their lives.
On the other hand, the concept of frailty has become more important in gerontology and geriatric medicine. Frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes including falls, incident disability, hospitalization, and mortality. There are many elderly people becoming the need of nursing care via frailty. The frailty measures are new important issues in the integrated community-based care system. Ministry of Health, Labour and Welfare will work on frailty measures of the elderly from fiscal 2016.
In order to structure the integrated community-based care system and to improve the quality of comprehensive care in the regions, it is critical to strategically use the regional activities that presently exist in each local region as well as new regional resources that might be created out of changes in the social environment in the future.
At the same time, it is likewise necessary to strengthen the coordinating functional capability to link information-based support to the specific care services. Social and community prescription is a strategic management tool that links the non-specialized service to the specialized service of the integrated community-based care system. We can strengthen the coordinating function by building up the system of social and community prescription.
