The long-term care insurance (LTCI) system was introduced in Japan in 2000 to address the demands of older persons with disabilities based on the concept of a user-oriented social insurance system with support for independence. Older people with a certification for LTCI service needs can utilize facility services, in-home services, and community-based services depending on their physical and cognitive impairments. After the implementation of the LTCI system, there was a rapid increase in persons certified for LTCI service needs, with a corresponding increase in the financial burden on the government. Therefore, the Japanese government started a disability prevention program in which older people were screened for frailty by the Kihon checklist in addition to a high-risk approach with appropriate prevention programs in each community. After unsatisfactory outcomes of the high-risk approach for disability prevention, the government changed the primary strategy to a community-based population strategy to build a community to seamlessly provide preventive, medical, and long-term care and welfare and housing services to all individuals. Further improvement of the community-based integrated care system is needed for healthy aging in a superaged society.
Keywords: Disability; Integrated health care systems; Long-term care insurance.