日本社区嵌入式养老发展历程及其经验

The Progress of the Community-based Integrated Care System for the Elderly in Japan and its Experiences

日本作为世界人口老龄化程度最高的国家,一直面临着少子老龄化带来的养老压力。通过对日本近30年来推进的社区嵌入式养老服务的分析发现,日本政府本着在地安养的原则,先后推出金色计划(1989年)、新金色计划(1994年)、金色计划21(1999年)、介护保险(2000年)、区域密集型服务(2006年)、区域综合照护体系(2010年)、橙色计划(2012年)、新橙色计划(2015年)等,持续推进社区嵌入式养老服务,逐步形成了"自助、他助、公助、共助"相结合的多主体参与、多元服务的社区嵌入式养老服务模式,其经验值得我国借鉴。

As the oldest population in the world,Japan has been faced with the pressure of supporting the elderly due to the low fertility and the ageing population. Following the principle of ageing in place,the Japanese government has continually proposed a series of plans to promote the community-based integrated care system for the elderly in the recent three decades. These plans include the Gold Plan（ 1989）,New Gold Plan（ 1994）,Gold Plan 21（ 1999）,Long-Term Care Insurance（ 2000）,Regional Integrated Care System（ 2006）,Five-Year Plan for Promotion of Measures Against Dementia（ Orange Plan）（ 2012）, National Dementia Strategy（ New Orange Plan）（ 2015）,etc. Consequently,Japan has equipped the model with a wide range of services and the participation of multiple subjects featuring a combination of ＂self support,peer support,public support,and society coalesced support ＂. This paper,based on the analysis of the ageing process in Japan,systematically recaps the progress of the community-based integrated care system in Japan and summarizes the experiences in its conceptualization,means of integration in communities,mechanisms of implementation,supporting measures,political adjustments,and the construction of the professional team. The aim of this paper is to provide China the reference for the development of the community-based integrated care system.