Long Term Care Financing

Forecasts predict that those in need of long-term care in Europe will double in the next 50 years. This book offers a full understanding of the institutional responses and mechanisms in place to finance old age and provides analysis of demand and supply factors underpinning the development of financial instruments to cover long-term care in Europe.

"This open access book outlines the challenges of supporting the health and wellbeing of older adults around the world and offers examples of solutions designed by stakeholders, healthcare providers, and public, private and nonprofit organizations in the United States. The solutions presented address challenges including: providing person-centered long-term care, making palliative care accessible in all healthcare settings and the home, enabling aging-in-place, financing long-term care, improving care coordination and access to care, delivering hospital-level and emergency care in the home and retirement community settings, merging health and social care, supporting people living with dementia and their caregivers, creating communities and employment opportunities that are accessible and welcoming to those of all ages and abilities, and combating the stigma of aging. The innovative programs of support and care in Aging Well serve as models of excellence that, when put into action, move health spending toward a sustainable path and greatly contribute to the well-being of older adults."--Provided by publisher.

This book examines the challenges countries are facing with regard to providing and paying for long-term care.

Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

This book uses a revised version of Kingdon’s multiple-streams framework to examine health financing reforms in China, Hong Kong, Taiwan, and the Republic of Korea (ROK) as well as long-term care insurance (LTCI) reforms in Japan and Singapore. It shows that the explanatory power of the multiple-streams framework can be strengthened through enriching the concepts of policy entrepreneurs, ideas, and windows of opportunity in the original framework as well as bringing the theoretical lens of historical institutionalism into the framework.

Long-term care services include a broad range of services that meet the needs of frail older people and other adults with functional limitations. Long-Term care services provided by paid, regulated providers are a significant component of personal health care spending in the United States. This report presents descriptive results from the first wave of the National Study of Long-Term Care Providers (NSLTCP), which was conducted by the Centers for Disease Control and Preventions National Center for Health Statistics (NCHS). This report provides information on the supply, organizational characteristics, staffing, and services offered by providers of long-term care services; and the demographic, health, and functional composition of users of these services. Service users include residents of nursing homes and residential care communities, patients of home health agencies and hospices, and participants of adult day services centers.

This brief is part of a series about financing health and social long-term care: lessons for low- and middle-income countries (LMICs). The number of people aged 65 years and older will increase in LMICs, where most older people will be living by 2050. Many people in LMICs will experience the onset of age-related health problems before the age of 65 years. Long-term care (LTC) can include some acute care medical services delivered in health facilities, but it primarily refers to support provided outside of the health system by caregivers in institutions or at home to allow people to maintain their routine activities. Individuals’ unmet needs increase the demand for LTC. Without formal LTC services and systems, the costs of LTC shift to the family. Informal caregivers, primarily women, may need to reduce their working hours or leave the labour force prematurely, placing pressure on the economy and household resources. The availability of informal caregivers has declined along with decreases in fertility and family sizes, and increased opportunities for women in the formal workforce. In the absence of formal LTC services and systems, individuals seek care in the acute care medical system, which can increase health care costs while offering suboptimal care for older adults. People underestimate their need for LTC, even though many may require intensive support or institutional care that may exceed their income. Given the market failures of LTC insurance, public intervention is well-justified to meet this demand.

This brief is the seventh in a series discussing long-term care financing in low- and middle-income settings. The focus is quality and value in long-term care.