Integrated Health and Social Care in Communities: Case of Minami Medical Co-op

Japan is on the front line of the aging society with 26.7% of population being 65+. Such a high and rapidly aging population causes a number of problems; shrinking workforce and consumption, depopulation and isolation,... [ view full abstract ]

Japan is on the front line of the aging society with 26.7% of population being 65+. Such a high and rapidly aging population causes a number of problems; shrinking workforce and consumption, depopulation and isolation, decaying infrastructure and public services, increasing costs for health and social care. The universal health care was accomplished in 1961 while the Japanese-style welfare society expecting women as hidden assets was once praised but this idea was soon abandoned as unrealistic. In the 1990s, the government introduced radical quasi-market reforms covering all aspects of social welfare system and launched the Long-term Care Insurance (LTCI) in 2000. To cope with the ever-increasing costs involved in LTCI and fill the gap in service provision, a proposal for Integrated Community Care (ICC) was made recently aiming at the integrated provision of housing, health and social care, prevention and livelihood support in communities toward 2025.
Health co-ops have sought to build healthy communities combining health promotion, health care and social care since the 1980’s. They have multi-stakeholder membership and governance structure with a majority general consumers and a minority health professionals. They have promoted member participation through learning and checkup of health in neighborhood groups, reflecting their voice in the co-op administration through the boards/committees and created guidelines for health and social care to be offered in health co-ops.
Minami Medical Co-op in Aichi Prefecture was founded in 1960 to serve population affected by Isewan Typhoon which took more than 5,000 residents. It made an organic growth involving more members and building new clinics. When LTCI Act took effect in 2000, it entered in the elderly care as a natural extension of health care and made substantial investment in facilities such as group homes, day service centers while training home helpers among members. When its central hospital needed to be rebuilt in 2010, the planning involved 1,000 members. Consumer members took part in a range of volunteer activities, in looking for the sites of care facilities and even in finding professional staff. In 2015 the multi-generation flat equipped with medical/social care facilities was built. Such co-op’s initiatives were designated to be a model of ICC by the Ministry.
This paper begins with the institutional framework on health/social care and describes how health co-ops have developed health and social care services. Then it will analyze how Minami Medical Co-op has made a number of innovations.