2023 Volume 72 Issue 5 Pages 387-394
A community-based integrated care plan (long-term care insurance plan), formulated by each insurer every three years, serves as the basis for insurers to construct community-based integrated care systems tailored to local circumstances. However, plans by many local governments simply list individual projects in accordance with the guidelines of the Ministry of Health, Labour and Welfare, and the descriptions of the ultimate goals and how each project works together to achieve the goals are also abstract. In reality, we have not been able to adequately explain how we are moving toward this goal.
This paper summarizes the methods and issues that insurers should face in steadily promoting the construction of community-based integrated care systems while improving their insurance functions in the future, based on the concept of “community design.”
Community design is a method of designing a combination of initiatives that are necessary at the current stage using the backcasting method while setting a long-term image of what the community will achieve.
The goal images that insurers aim for are defined as “continuing to live in the familiar area” and “independent daily life/living one's own way,” and the prerequisites for achieving this are intermittent changes in the recipient's living environment. A situation in which a person's behavior is affected is classified as a situation in which deterrence is required. This is seen as a shift from “a system that matches people to care” to “a system that matches care to people.” It also introduces several survey and analysis tools such as the “Home Care Improvement Survey” that are used to quantify the evaluation of system changes.
In addition, community support programs implemented to achieve the goals of the community-based integrated care system can be categorized into two types: “multidisciplinary collaboration/medical and nursing care collaboration” and “community development” and the principles of each approach are different. These are explained with reference to the “flowerpot of community-based integrated care.” Finally, the conditions necessary for insurers to exercise their community design functions and future challenges are discussed.
