지역포괄케어시스템의 구축배경과 추진방향

다국어 초록 (Multilingual Abstract)

The aim of this paper is to summarize the structural background of integrated commnity care system in Japan, along with their philosophy, operational conditions, and future directions and challenges to suggest the direction in which such systems should take in a South Korean context. In Japan, where the elderly care insurance system was launched in 2000, discussions have begun in earnest on how to build community care networks, primarily in connection with the Integrated Community Care Study Group founded in 2008 along with reforms to the existing arrangement. Systems that place significance on providing assistance for the home lives of the elderly are defined as “community systems that enable the appropriate provision of a variety of life support services, including medical treatment, long-term care, and welfare services in order to ensure safety, security, and healthcare requirements of daily life, with housing provided according to individual needs.”
The basic philosophy of this system involves “independent living support” and “maintenance of dignity” for the elderly as the goals of long-term care insurance. It is comprised of the following five elements: housing and way of life; lifestyle support; medical treatment and nursing; long-term care and rehabilitation; and health and prevention. In addition, the provision of integrated community care is premised on the basic concepts of self care, mutual aid, shared support, and public assistance, whose respective roles and ranges may vary over time and place.
In Japan, where discussions toward such systems are ongoing, it will be necessary to build future systems that incorporate a community development (“Machizukuri”), perspective. Emphasis has also been placed on the importance of ensuring the quality of death at the terminal life-stage. Future challenges include 1) the development of tools to diagnose current conditions in target communities, 2) a study of how networks take shape and work together between multiple agencies and across multiple disciplines, and 3) the development of a scale for evaluating such systems.
South Korea is now experiencing social challenges similar to those facing Japan. Thus, it will be necessary in the future to develop integrated community care system on a Korean model. To this end, it will be necessary to assess the various resources that already exist in local communities and examine possibilities for their mutual collaboration. At the same time, it will be necessary to undertake further examination by collecting case studies that correspond to South Korea’s existing system.