| Summary: | <span style="line-height: 200%;" lang="EN-US"><p>Introduction: In 2000, Japan implemented a mandatory long-term care insurance system. With the rapid growth of the system, problems became apparent. Several critical alterations were made to the long-term care insurance system, particularly with respect to integrated care.</p><p>Methods: This paper elucidates the policy trends that led to the reforms of the long-term care insurance system, which included new concepts of ‘integrated care’ and ‘community-based care’, an agenda of cost containment and service streamlining, and coordination with medical care.</p><p>Results: Community-based integrated care, as envisaged in the long-term care policy, includes not only the integration of medical care into service provision but also the inclusion of the informal mutual aid, oversight of for-profit providers by an administration that ensures users are not exploited and coordination between systems that cover different geographical areas.</p><p>Conclusions: Japan’s experience in community-based care integration suggests that this project requires multi-faceted care integration in local communities. In the future, it will be necessary to conduct empirical assessments of the effectiveness of these measures.</p></span>
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