Community-Based Integrated Care Systems in Japan: Focusing on Spatial Structures and Local Governance

Abstract

This paper clarifies the factors causing spatial and regional variations in community-based integrated care systems by focus-ing on local governance. Furthermore, it extracts the characteristics and problems of each variation. One of the factors which causes regional variations is differences in the population size of municipalities. Clearly, this is due to the reference population, which affects the establishment of comprehensive community support centers and demarcation of the sphere of daily life sphere of the senior service area In municipalities with smaller populations, local governance focuses on the sphere of daily life that centers around the community care conference. However, the multilayered local governance structure composed of the sphere of daily life and an entire municipality becomes more complex as the population increases. The result is an emphasis on the control of decentralized local governance in all municipal areas, which considers the regional characteristics of each municipality and the location of comprehensive community support centers in the sphere of daily life.