Issues related to collaborative partnerships in community-based integrated care systems －Comparison between professionals in urban and rural areas－

地域包括ケアシステムにおける協働連携に関する課題 ―都市部と農村部の専門職による比較から―

Issues related to collaborative partnerships in community-based integrated care systems －Comparison between professionals in urban and rural areas－

Degree Grantors Yamaguchi Prefectural University

By 2060, approximately one in every 2.5 people in Japan is expected to be elderly, and there is an urgent need to establish a sustainable system of collaboration and cooperation based on human networks involving diverse stakeholders, organizations, and facilities, including local residents. However, many local governments still face challenges in establishing comprehensive community care systems, such as a shortage of people to support such systems and difficulties in providing services.
The purpose of this study is to clarify the actual state and issues of collaborative partnerships in community-based integrated care systems. In particular, we focus on the roles of professionals and the nature of collaboration in urban and rural areas, and through a comparison of the two regions, we present insights that will contribute to the future operation of community-based integrated care systems.
In Chapter 1, we conducted a literature review on the policy background and contemporary issues of the community-based integrated care system, clarifying the research questions and analytical perspectives of this study. In Chapter 2, we outlined the research methods and definitions of terms, and organized the research framework. In Chapter 3, we analyzed the narratives of professionals in urban and rural areas using text mining to clarify the actual state of collaboration and cooperation. In Chapter 4, we examined the operational challenges and future directions of the community-based integrated care system through a comparison of the two regions.
The analysis revealed that urban areas faced issues such as a shortage of informal service providers, one-way communication due to the vertical structure of government, and a lack of facilities. Meanwhile, rural areas faced a combination of issues, including a shortage of professionals and social resources, poor transportation, a decline in community activities, and a lack of learning opportunities. Additionally, in rural areas, it became clear that many elderly people and their families desire long-term care in residential facilities due to the fragility of caregiving capacity.
This means that in urban areas, there aren't enough professionals to handle the number of people who need their help, so they can't do their jobs properly. This shortage also leads to a vicious cycle where it's hard to keep up quality and hold training sessions and study groups to maintain standards. In rural areas, there are even fewer professionals to begin with, and there aren't enough offices, so each professional has to take on a wider range of responsibilities. In other words, it became clear that in
urban areas, although systems and services exist, there is a problem in that human resources and operations are not keeping pace, while in rural areas, there is a lack of systems and social resources to begin with, and geographical and demographic barriers are significant obstacles to collaboration and cooperation.

Creators Koga Toshinori