Cooperation is one of the methodologies of joint production of goods and services. In this paper, the term “cooperation” is used as a general name for complimentary relationships among organizations and occupations in healthcare, including integration, networking, coordination, etc.
Section two shows the differences among the caring theories, the management theories, and the policy theories, all related to the cooperation in healthcare field. Section three describes the reason why cooperation in the（acute）medical care sector is requested. The meaning of aiming at cooperation is emphasized because we are facing the crisis of the social security system in Japan, especially the medical insurance system for the workers employed by small-scale employers. Section four explains why cooperation between medical care sector and long-term nursing care sector is requested. Section five considers why the cooperation in the long-term nursing care field is requested. Additionally, the section deals with the integrated community care system which our country aims at 2025.
Section six changes the theme to the question regarding“the cooperation of whom, by whom, for whom?” Finally Section seven describes the expectation to future.

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In the health care arena, the concept of “integration” has been discussed mainly by the public sectors such as local governments and leading regional tertiary care hospitals in Japan. In this chapter, we focus on “the company-driven integration” as another approach to develop and promulgate health care service integration. The reasons for this are as follows. First, private companies should be involved in promoting integration because of resultant opportunities to develop their social values and provide benefits in society. This is one element of corporate social responsibility. Second, private companies have accumulated not only knowledge and skill but also experience in strategic development based on the value chain concepts in numerous industries.
Based on our experience and analysis of the business development of home oxygen therapy in Teijin Ltd., the process of developing the “integration” of related the roles and responsibilities, we identify and discuss seven stages and clarify the key success factors, These key success factors are:mind-set to develop the values of patients, shared vision not consensus, and marketing skills and expertise for broadening geological scope by configuration and coordination, standardization and localization, and transferring skills and knowledge to other regions.
We believe private companies will contribute to the creation of social values in the health care field by utilizing their marketing perspectives, as well as their accumulated knowledge and experience, to improve the efficacy and efficiency of providers in the health care system.

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The purpose of this paper is to consider region-based management methods of long-term care for the elderly within urban areas with a rapidly aging population. In doing so, we will use three case studies as a basic framework for public long-term care insurance services：an example of a medical association-led group in Onomichi City, Hiroshima Prefecture；an insurer-led example in Wako City, Saitama Prefecture；and an elderly home operator-led example in Nagaoka City, Niigata Prefecture. We use a service blueprint methodology from the field of service management in our analysis.
As a result of our research, we found that the Onomichi model of medical association-led care primarily functioned as in-home care, seamlessly supplying everything from primary care to hospice care. The second, Wako’s insurer-led model, is based on preventive care and the prevention of serious illness, and can be extremely efficient if coordinated with the centrally-planned care facilities planned by local government. The third, Nagaoka’s elderly home model, has operators of these homes placing care managers and multi-disciplinary teams in each region in order to heighten company teamwork and increase information sharing of users of the service. The conclusion of this study is that Wako’s insurer-led model is the most desirable, considering the efficient regional management systems in urban areas. However, additional changes such as the creation of an organization to consider separate medical specialists are likely necessary for serious cases or to provide hospice care.

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Cooperation among different types of occupations and functions has been increasingly important in Japan. The underlying factors are increasing needs for medical treatment/care in the aging society, declining productive population, and the worst financial condition among advanced countries.
However, it is not easy for many healthcare staff/providers to cooperate among different types of occupations and functions. This paper not only analyzes how to minimize impediments against such cooperation, but also examines how to effectively maximize promoting factors.
Firstly, three structural impediments(mismatches)are analyzed;a mismatch between types of cooperation and types of measures(organizations), a mismatch/lack of human resources, and a mismatch in development stages. This paper also examines how to deal with each mismatch effectively.
Secondly, types of cooperation are categorized in terms of the degree of specialization, the degree of interaction among healthcare staff/providers, types of services, and distribution of patients/users. This paper considers key success factors in each category.
Finally, diversity management among different types of occupations and functions and co-evolution between cooperation and sound management are examined.

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This study was conducted to examine the support contents of municipality services, in relation to outreach for persons receiving public assistance who are “difficult to engage,” such as untreated persons or those who have dropped out of receiving psychiatric services.
An interview was carried out with nurses and psychiatric social workers responsible for outreach support for people with mental health problems who were receiving public assistance. The interview data were qualitatively analyzed.
Clients who had difficulties in engaging interpersonally did not recognize their need for assistance, and it was difficult for health care professionals to establish relationships with them. The professionals identified the need to have sufficient process time to develop relationships with their clients and families before proceeding with their work. As one of the main roles of health professionals, nurses have been expected to provide medical care, and psychiatric social workers have been expected to provide case management. However, more effectiveness was recognized in a team approach than in the single occupational approach.
For developing outreach service using a nongovernment organization in the future, it will be necessary for health care professionals to acquire skills in relationshipbuilding, family assessment, care management and coordination. In addition, education on these skills will become necessary in professional education.

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