Long-Term Outcomes and Enabling Factors of Integrated Care in a Rural Aging Community in Japan: A Qualitative Study

Japan faces one of the world's most rapidly aging populations, particularly in rural and mountainous regions. Since 2003, Japan has promoted the Community-based Integrated Care System, yet implementation and outcomes vary by region. This study aimed to explore the long-term outcomes and enabling factors of integrated care in a highly aged, depopulated rural town.

A qualitative study using semi-structured interviews was conducted with eight healthcare and welfare professionals involved in long-standing community care in Nichinan Town, Tottori Prefecture. Participants were selected via convenience and snowball sampling. Data were analyzed using the Steps for Coding and Theorization (SCAT) method.

Three main categories were identified: (1) effects of long-term integrated care, including the development of a culture of information sharing and improved interprofessional collaboration; (2) enabling factors, such as the central role of the Integrated Community Care Support Center, physician participation in case conferences, and the structured sharing of good practices; and (3) contextual challenges, such as workforce shortages, evolving care needs, and limited informal support.

Sustained integrated care in aging rural communities can foster effective interprofessional collaboration and enhance care quality. A neutral coordinating entity such as the ICCS Center, along with regular sharing of practical case outcomes, may play a vital role in maintaining long-term integration. These findings offer insights for other aging, underserved regions aiming to implement or strengthen integrated care systems.