Noda Shinichiro, Hernandez Paul Michael R, Sudo Kyoko, Takahashi Kenzo, Woo Nam Eun, Chen He, Inaoka Kimiko, Tateishi Emiko, Affarah Wahyu Sulistya, Kadriyan Hamsu, Kobayashi Jun
Bureau of International Health Cooperation, National Center for Global Health and Medicine, Japan, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, JP.
Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila, 625 Pedro Gil Street, Ermita, Manila, PH.
Int J Integr Care. 2021 Apr 6;21(2):1. doi: 10.5334/ijic.4739.
Japan's health policies to address the most advanced-aged society have been the target of focus in Asia, but no studies have investigated this issue using tools for cross-country comparisons.
A cross-country study design was used to compare healthcare reform policies with a framework in Japan, Korea, Thailand, China, Indonesia, and the Philippines. Data were collected via document reviews and key informant interviews.
Three distinctions were identified. First, all countries except for the Philippines have policy decisions regarding reforms for the existing service delivery systems for healthcare, long-term care and welfare. Second, the most extensive service delivery reform is currently being implemented in Japan, whose system is shifting to primary health care. Third, the direction of the transformation of service delivery system is different between Thailand and China despite a similar level of ageing society. China has made progress on facility-based care integration between health and social care, whereas Thailand is focusing on home-based care.
Doctor and hospital-based healthcare delivery system requires more drastic reform for an aged society. This fact implies that strengthening primary health care is not only useful for current health issues but also an investment for the aged society near future in low- and middle-income countries.
日本应对超老龄社会的卫生政策一直是亚洲关注的焦点，但尚无研究使用跨国比较工具来调查这一问题。
采用跨国研究设计，将日本、韩国、泰国、中国、印度尼西亚和菲律宾的医疗改革政策与一个框架进行比较。数据通过文献回顾和关键信息人访谈收集。
确定了三点差异。第一，除菲律宾外，所有国家都对现有的医疗、长期护理和福利服务提供体系的改革做出了政策决策。第二，目前日本正在实施最广泛的服务提供改革，其体系正在转向初级卫生保健。第三，尽管泰国和中国的老龄化社会程度相似，但两国服务提供体系的转型方向不同。中国在基于机构的卫生与社会护理整合方面取得了进展，而泰国则侧重于居家护理。
以医生和医院为基础的医疗服务提供体系需要针对老龄社会进行更彻底的改革。这一事实表明，加强初级卫生保健不仅对当前的卫生问题有益，也是中低收入国家对不久将来老龄社会的一项投资。
