Discussion
Thus far we have outlined how, in recent years, community-
based integrated care has become part of the
long-term care policy agenda, as well as trends in the
long-term care insurance system and health care system
for integrated care. Given governmental concern
with cost containment, the encouragement of community-
based integrated care systems has been premised
on the notions that, first, the care is provided from a
range of resources, including mutual aid and self-help,
and, second, that those who need intense long-term
care will be given priority in the use of formal system
resources. Based on these assumptions, new services
with enhanced health care functions have been introduced
to long-term care insurance system. Reforms
aimed at the expansion of home-based medical care,
combined with monetary incentives for medical and
long-term care collaboration, have been initiated. The
long-term care insurance insurers - the municipalities -
have been required to show a positive commitment to
the management of care resources within the community
and to coordinate overlapping services.
To answer the questions set out at the beginning of this
paper, we must look at the background of the movement
towards community-based care. When long-term
care insurance was introduced, the long-term care system
became independent of the medical care system,
offering primarily social care and welfare services.