1980年代以降の医療供給制度改革の展開

―政策学習論の視座から―

抄録

Social hospitalization of the elderly people has said to be the biggest pathology in the Japanese medical supply system and it was the main policy problem to be solved for a long time. Although it was not completely solved, it is just in sight in the Ministry of Welfare (Ministry of Health, Labour, and Welfare) having promoted differentiation of medical function and promotion of coordination policy since 1980’s. The policy consists of three points; first one is to differentiate medical function between acute care and chronic care, second one is to promote discharge by Bundled payment in revision of medical fee, third one is to provide both facility and in-home care service. This report explores about the factors that the Ministry of Welfare could promote through the view point of “Policy Learning”. This report revealed that the Ministry of Welfare has learned the elements of European and American eldercare service formulated the policy by constraining it to existing institutions under the administrative reform since 1980’s.