The aging of East Asian countries, including China and Japan, is much faster than in the United States and Europe, and it is necessary to respond to the rapid growth in demand for long-term care.In China, where a nationwide trial of a long-term care insurance system is under way, it is necessary to develop social resources for long-term care. Therefore, prevention of recurrence and aggravation is very important to focus on the disease and condition of the elderly people.

It is important to improve health so that people do not get sick, but because the target population is large and healthy, the cost effectiveness tends to decrease. On the other hand, approaches focusing on diseases and conditions have a lot of evidence in each field of medical care and long-term care and are effective even if limited resources are invested because they are approaches to high-risk persons. In addition, elderly people with a medical history tend to be more susceptible to infectious diseases than those without such a history, which is effective from the viewpoint of public health as well as care prevention.

In Japan, preventive care is now operated on a regional basis, and in advanced regions, the government has taken the initiative in identifying high-risk elderly people and focusing on the introduction of initial services, resulting in a reduction in the proportion of elderly people requiring long-term care. Regional efforts, on the other hand, vary widely, and not necessarily produce results in many regions.

If Japan's trial and error experience is to be used to respond to China's aging population, it is necessary for the government to take the lead in curbing the growth of long-term care demand, to make it easier for the elderly people to use not only public services but also health services provided in the market, and to work on individual management personalized to the elderly's diseases and conditions.

In order to solve these problems, we propose the following three measures: introduction of personal management services by medical institutions integrated with medical examinations; establishment of an integrated research system between health service providers and medical institutions to verify the effectiveness of prevention; and introduction of incentives for elderly people to use prevention care services.

We hope that this paper will help consider health care and long-term care policies in preparation for China's rapidly aging population.

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