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KMID : 1142920190030010043
Public Health Affairs
2019 Volume.3 No. 1 p.43 ~ p.59
A Review of Community Care in the UK and Japan: Focused on the Background of Legislation and Strategies to Integrate Health and Social Care
Jang Won-Mo

Lee Min-Young
Heo Hyun-Hee
Abstract
Objective: This study aimed to investigate the contextual background of legislation related to community care and case studies of coordination and integration of social care in health care, which serve the needs of older persons in the UK and Japan. We examined how community care evolved, and its progresses in national polices and strategies to integrate health and social care.

Methods: A literature review was conducted using an historical and comparative approach based on Kingdon’s Multiple Streams Framework. We used purposive sampling in the selection of countries and case studies of community care.

Results: In the context of ageing, community care evolved depending on how the governments of the UK and Japan have policy orientation on social welfare spending. We examined similarities in the way the governments of both countries are integrating social services into health care by supporting joint working, making interprofessional care teams the focal point for care managements, and local government-led social welfare services responsible for provision of community-based social care. Contextual differences were found between both countries, whereby the policy direction of Japan is to have in place structures and mechanisms that actively connect health and social care with integrated delivery system and a newly created fund based on increase of consumption tax to incentivize and strengthen integration.

Conclusion: Both countries may differ in the means to coordinate and integrate health and social care but the net result is expanded community care capacity. In a context of changing health care demands, community care policies are a vital mechanism for providing patient-centered integrated care services. Future research on decentralization and community engagement as prerequisites and facilitation of community care should be further investigated.
KEYWORD
Community Care, Integration, Coordination, Integrated care, Health care, Social care
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