The present condition and future prospects of the role of public health centers in health care and long-term care integration

Abstract

This paper describes the present condition of the role of public health centers in health care and longterm care integration and discusses the future prospects of such centers. 　Currently, the Ministry of Health, Labour and Welfare encourages municipalities to focus on the home medical care cooperation promotion business in collaboration with district medical associations. The business was founded in 2015 to implement a long-term care insurance business plan, and all cities, towns, and villages are expected to participate by 2018. However, few networks have been established and very little relevant knowledge about setting up a promotion business has been accumulated at the municipality level. In addition, a discharge adjustment for a person requiring long-term care often necessitates the coordination of resources that extend beyond the geographical boundary of a municipality, making it difficult for a municipality to manage a discharge adjustment rule within its administrative range. 　Prefectural public health centers, on the other hand, have promoted construction of home medical care systems at secondary medical care areas and have indicated positive results of such a system, which covers a larger geographical area than a municipality, as part of health care planning in cooperation with district medical associations, home care support medical offices or hospitals in the city, and district public health centers. Prefectural public health centers are expected to play a role in helping municipalities promote home medical care and long-term care integration from broad and complimentary perspectives. 　We show the present condition of the role of public health centers in health care and long-term care integration, which was gleaned from a questionnaire survey and a field hearing investigation carried out by us. We then discuss the future prospects of the role of such centers by referring to these survey results as well as the outcomes of activities carried out by the Japanese Association of Public Health Center Directors and the Ministry of Health, Labour and Welfare community health synthesis promotion business.