我國老年人口至2008年已超過10%，人口老化持續進展，相對造成失智、失能須照護人口數增加。日本於2000年因高齡化社會的進展，長期照護服務需求增加，但福利法人所提供的服務不敷使用，以致於形成不需住院的老人佔用醫療資源，因此於當年4月開始施行介護保險制度，運用市、町、村地方政府提供在地老化之照護，透過福利機構協助，減少財政赤字，並促進長期照護市場供需平衡。在國內長期照護十年計畫中發現，各縣市長期照護管理中心執行力不一，縣市資源落差大，服務提供單位不足，均影響服務使用之意願。故於2009年8月參訪民風習俗較為相近之日本介護保險機構，本文將日本介護保險執行之現況及改革重點，加以整理，內容值得做為台灣發展長期照護保險制度之參考。

The proportion of elderly (65 years of age and older) in Taiwan has exceeded 10% since 2008. With more elderly, the number of patients suffering from dementia and disabilities has also been rapidly
increasing. Japan also has been facing increasing demand for long-term care due to an aging society.
Prior to 2000, social welfare programs in Japan, working to cope with changing needs, typically pro-vided insuffcient services, and geriatric patients were hospitalized unnecessarily, wasting medical re-sources and causing undue patient hardship. In response, Japan launched its long-term care insurance program in April 2000. Under the program, city, town and village-based organizations should take responsibility for providing care to the elderly in their place of residence. The program signifcantly improved previous fnancial shortfalls and long-term care supply and demand has been met by exist-ing social welfare organization resources. In Taiwan, the provision of long-term care by county / city authorities has proven inconsistent, with performance deemed poor after its frst decade of long-term care operations. Service was found to be affected by differences in available resources and insuffcient long-term care administration. The cultures of Taiwan and Japan are similar. The authors visited the Japan Long-Term Care Insurance Institute in August 2009. Main issues involved in the implementa-tion and evolution of the Japan long-term Care Insurance are reported on in this paper. We hope such may be useful information to those working to develop long-term care programs in Taiwan.