Transformation of healthcare models and creation of integrated care systems in an aging society: A comparative perspective of the Netherlands, Japan, and China

Faced with the global challenges of population aging and a surge in dementia cases, healthcare models worldwide are undergoing profound transformation. The Netherlands' "dementia villages" concept simulates living environments, with their antipsychotic drug usage rate (11%) being significantly lower than in traditional facilities (52%). Japan has established over 12,000 "small-scale multi-functional" care facilities, striving to achieve "life in the community." Meanwhile, China is promoting community-embedded elderly care models, exemplified by Shanghai's plan to increase the number of daycare centers from 720 in 2019 to 919 by 2024, establishing a "15-minute elderly care circle." This commentary compares the Netherlands, Japan, and China across four dimensions: aging trends, innovative care models, the development of multifunctional healthcare systems, and end-of-life care philosophies. It assesses current policy developments and practical challenges, proposing that future sustainable care systems should integrate healthcare with community resources, institutional frameworks with ethical considerations, technological advancements with humanistic values, and education on death with the preservation of life with dignity.