「地域包括支援中心」在長期照護發展新動向－－以日本東京八王子市為例

Community Integrated Support Centers: The Experience of Hachioji, Tokyo, Japan

根據內政部2015年底人口統計資料顯示，臺灣65歲以上者近281萬人，占總人口12%，推估在2025年，將邁入聯合國定義之超高齡社會，長期照護需求日益明顯，長期照護政策遂成為我國發展之重點。相較之下，日本現在老人人口已超過25%，其於2000年起開辦介護保險至今，已推出許多整合式長期照護體系，強化居家與社區式長期照護服務，亦成為鄰近亞洲國家長期照護的典範依據。因此，本文針對「地域包括支援中心」在日本長期照護發展現況及動向加以整理，內文探討日本介護保險發展現況、最新整合式社區照護體系之醫療、介護、介護預防、住宅、生活支援等服務內涵，以及「地域包括支援中心」之公共衛生護理師、社工師、照管專員等照護專業人力的功能，並介紹民生委員角色的配置，以推動在地服務，期能達到在地老化完善的照護。借鏡日本長期照護發展經驗，以作為臺灣未來發展長期照護之參考。

The proportion of elderly in Taiwan reached 11.99% of the population in 2014. Further, Taiwan is expected to become a super-aged society, as defined by the United Nations, in 2025. Elderly and long-term care needs have increased dramatically and long-term care (LTC) has become an increasingly important focus of policymaking. Japan, already a super-aged society, enacted LTC insurance in 2000 and has since implemented comprehensive LTC services nationwide. This article describes the evolution of the LTC insurance plan in Japan and the function of the Community Inclusive Care System. The latter integrates medical care, homecare services, LTC services, living support, and Community Integrated Support Centers with public-health nurses, social workers, and care managers in order to facilitate the construction of services that enhance aging in place. The authors hope that learning from Japan's experience in developing LTC will facilitate the future development of LTC services in Taiwan.