Toward an Integrated System of Service Delivery: Policy Framework, Instruments, and Challenges of Japan's Community Total Care System

Sunday, 10 July 2016: 11:00
Location: Hörsaal 33 (Main Building)
Oral Presentation
Koichi HIRAOKA, Ochanomizu University, Japan
Facing the projected rapid increase in the elderly population, particularly those aged 75 years or over, during the next decade, the Japanese government has pursued the creation of an integrated system of service delivery called the Community Total Care System (Chiiki-hokatsu-kea-sistemu in Japanese, CTCS) as the most important goal of long-term care policy.
The CTCS is intended to improve the efficiency of the system for service delivery and to guarantee independent living for older people, by integrating health, social, and related services and by shifting resources from facility-based care to community-based care.
This study aims to elucidate the nature of the CTCS, to analyze the newly introduced policy instruments for the improved functioning of the CTCS, and to examine the challenges facing the CTCS.
For these purposes, this study first examines the concept and framework of the CTCS in light of international discussions about integrated delivery systems and Japan’s CTCS in comparison with its equivalents in the United States, the United Kingdom, France, and Sweden.
Second, this study focuses on some of the policy instruments that have been introduced recently for the improved functioning of the CTCS (e.g., all-inclusive payment of service costs to service agencies, the supportive housing scheme for the elderly, participatory governance of the local delivery system, utilization of information and communication technology (ICT) ), analyzing their characteristics and effectiveness based on a review of policy documents, journal articles, and empirical studies.
Finally, this study examines the challenges facing the CTCS, especially the development and evaluation of innovative programs that are customized for local circumstances, the improvement of the quality of supportive housing for the elderly, and improvement in training and working conditions of care workers.