DOI QR코드

DOI QR Code

The Institutionalization Process of the Visiting Rehabilitation System in Japan and the Challenges Faced in the Process

  • Lee, Minyoung (Department of Healthcare and Public Health Research, National Rehabilitation Research Institute)
  • Received : 2022.03.21
  • Accepted : 2022.04.25
  • Published : 2022.04.30

Abstract

Purpose: In Japan, the long-term care insurance and health insurance acts have stipulated the visiting rehabilitation system to provide support at the national level. The prior case of Japan would provide guidelines for seeking a suitable policy direction in South Korea. This study aims to examine the historical transition process of the visiting rehabilitation system in Japan, and the issues that emerged in the process of the institutionalization of this system. Methods: To examine the historical transition process of the system, the regulations announced by the government and their reports were reviewed. The relevant issues were qualitatively analyzed based on the opinions of scholars, therapists, and interested organizations that were reported in published papers on the topic. Result: The visiting rehabilitation system has been implemented in the following chronological order: The Health and Medical Service Act for the aged (1982-2006), the Health Insurance Act (1988-), and the Long-term Care Insurance Act (2000-). Currently, visiting rehabilitation is provided through hospitals, clinics, visiting nursing stations, etc. The following issues came to the fore in the process of the institutionalization of the system: (1) the complexity of the system, (2) the necessity of changing perceptions into a life model approach, (3) insufficient service provision by therapists, (4) the lack of human resources and an education system, (5) the lack of awareness of care managers and doctors about visiting rehabilitation, and (6) the necessity of quality enhancement through a team approach. Conclusion: It is deemed worthwhile to refer to the visiting rehabilitation system in Japan and the issues that emerged in the process of institutionalizing the system while seeking a policy direction for a similar system in South Korea.

Keywords

References

  1. Statistics Korea. 2021 senior citizen statistics [Internet]. South Korea: 2021 Sep 29 [cited 2022 Feb 28]. Available from: https://www.kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&aSeq=403253.
  2. Kim SY. Conceptualizing and strategies for Korean community care by comparison with overseas cases. Seoul, The Seoul Institute, 2018:1-170.
  3. Ministry of Health and Welfare. "Providing social services centered on home and local communities" Full-scale promotion of community care [Internet]. South Korea: 2018 Mar 13 [cited 2022 Feb 28]. Available from: https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=344177.
  4. Ministry of Health and Welfare. 「Community integrated care」, the first step in 8 local governments [Internet]. South Korea: 2019 Apr 4 [cited 2022 Feb 28]. Available from: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=3&CONT_SEQ=348925&SEARCHKEY=TITLE&SEARCHVALUE=%ED%86%B5%ED%95%A9%EB%8F%8C%EB%B4%84.
  5. Yi CH, Weon JH, Ok JY. House visits by physical therapist and patient needs. Phys Ther Kor. 2000;7(1):64-78.
  6. Kwon HJ, Kim YK, Moon TS et al. Research to the recognition and the need of development for proper insurance costs for home physical therapy, visiting physical therapy and school of physical therapy. KPTS. 2013;20(1):27-35.
  7. Jung DI, Kim CK, Ko DS. The survey of awareness and necessity on introduce home physical therapy in the long-term care insurance. Jour of KoCon a. 2014;14(6):298-306.
  8. National Rehabilitation Center. Guideline for the community-based integrated health promotion program [Internet]. Japan: 2021 Mar 4 [cited 2022 Feb 28]. Available from: http://www.nrc.go.kr/chmcpd/board/boardView.do?no=17825&fno=59&menu_cd=04_02&board_id=NRC_NOTICE_BOARD&bn=newsView&search_item=1&search_content=&pageIndex=1#.
  9. Ministry of Health and Welfare. Social services suitable for local characteristics are expanded [Internet]. South Korea: 2022 Feb 15 [cited 2022 Feb 28]. Available from: https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=370209&SEARCHKEY=DEPT_NM&SEARCHVALUE=%EC%82%AC%ED%9A%8C%EC%84%9C%EB%B9%84%EC%8A%A4%EC%82%AC%EC%97%85%EA%B3%BC.
  10. Park S. Achievement and challenges of the community social service investment project. Health and Welfare Policy Forum. 2016;237(1):45-60.
  11. Ministry of Health, Labor and Welfare. The long-term care act [Internet]. Japan: 2021 Apr 1 [cited 2022 Feb 28]. Available from: https://elaws.egov.go.jp/document?lawid=409AC0000000123.
  12. Ministry of Health, Labor and Welfare. The act of totally reservation of medical care and nursing care [Internet]. Japan: 2021 Apr 1 [cited 2022 Feb 28]. Available from: https://elaws.e-gov.go.jp/document?lawid=401AC0000000064_20220201_503AC0000000049.
  13. Ministry of Health, Labor and Welfare. The health and medical service act for the aged [Internet]. Japan: 2021 Apr 1 [cited 2022 Feb 28]. Available from: http://roppou.aichi-u.ac.jp/joubun/s57-80.htm.
  14. Ministry of Health, Labor and Welfare. The health insurance act [Internet]. Japan: 2021 Apr 1 [cited 2022 Feb 28]. Available from: https://elaws.e-gov.go.jp/document?lawid=211AC0000000070.
  15. Ministry of Health, Labor and Welfare. Overview of the revision of medical fees [Internet]. Japan: 2020 Mar 5 [cited 2021 Dec 28]. Available from: www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000106602.html.
  16. Japan association of home visit rehabilitation. Practice text for visiting rehabilitation. Tokyo, Seikaisha, 2016:6-42.
  17. Ministry of Health, Labor and Welfare. Proceedings and materials of long-term care benefit subcommittee of social security council 2001-2022 [Internet]. Japan: 2022 Feb 18 [cited 2022 Feb 27]. Available from: https://www.mhlw.go.jp/stf/shingi/shingi-hosho_126698.html.
  18. Ministry of Health, Labor and Welfare. Statistics on long-term care benefit expenses, etc. [Internet]. Japan: 2021 May 1 [cited 2022 Feb 28]. Available from: https://www.mhlw.go.jp/toukei/list/45-1.html.
  19. Ito T. The role of a physiotherapist in home-visit medical care. J Jpn Phys Ther Assoc. 2001;28(8):399-402.
  20. Ishikawa M. Cooperation between home rehabilitation, nursing and long-term care. The Japan Geriatric Society. 2001;38(1):153-5. https://doi.org/10.3143/geriatrics.38.153
  21. Japan Association of Rehabilitation Hospital and Institution. Outline of requests regarding the 2009 revision of long-term care insurance [Internet]. Japan: 2009 Sep 18 [cited 2022 Feb 28]. Available from: https://www.mhlw.go.jp/shingi/2008/09/s0918-12.html.
  22. Rehabilitation-related Organization Council, Japanese Physical Therapy Association. Proposals for improving the quality of rehabilitation services [Internet]. Japan: 2009 Sep 18 [cited 2022 Feb 28]. Available from: https://www.mhlw.go.jp/stf/shingi/0000057552.html.
  23. Ito T. Roles of physical therapists in the home-based rehabilitation. Rigakuryoho Kagaku. 2002;17(4):215-20. https://doi.org/10.1589/rika.17.215
  24. Yamanaga H. The reality of visiting rehabilitation. Jpn J Rehabil Med. 2001;38(1):732-4. https://doi.org/10.2490/jjrm1963.38.732
  25. Wada K. Current situations and future agenda of the home rehabilitation in the long-term care insurance. Sociogolica. 2013;37(1):99-108.
  26. Yoshihara K. Spread of "home-visit rehabilitation": role and problem of "long-term care insurance system" strengthening. The Study of Social Relations. 2008;13(2):91-119.
  27. Omori Y, Saito T. Efficient business management in community rehabilitation and community physiotherapy: rehabilitation from a home-visit nursing station as an example. J Jpn Phys Ther Assoc. 2011;38(1):45-50.
  28. Ito T. Specialty and possibilities of physical therapy in visiting activitieslooking 10 years later. J Jpn Phys Ther Assoc. 2015;42(4):327-31.
  29. Manabe K, Enoki H, Tanaka H et al. Current trends and issues of the home-based rehabilitation that reha-therapist recognized: from a study of recognition in Adachi award. Bulletin of Teikyo University of Science and Technology. 2015;11(1):33-9.
  30. The Japanese Association of Rehabilitation Medicine, Japan Association of Rehabilitation Hospital and Institution, Japanese Association of Homevisit Rehabilitation, Japan Association of Day Care. Functions required for home-visit rehabilitation [Internet]. Japan: 2017 Sep 6 [cited 2022 Feb 28]. Available from: https://www.mhlw.go.jp/stf/shingi2/0000176647.html.