Demand for Long-term Residential Care and Acute Health Care by Older People in the Context of the Ageing Population of Finland

Author(s):  
Mike Murphy ◽  
Pekka Martikainen
Author(s):  
He Chen ◽  
Jing Ning

Abstract Long-term care insurance (LTCI) is one of the important institutional responses to the growing care needs of the ageing population. Although previous studies have evaluated the impacts of LTCI on health care utilization and expenditure in developed countries, whether such impacts exist in developing countries is unknown. The Chinese government has initiated policy experimentation on LTCI to cope with the growing and unmet need for aged care. Employing a quasi-experiment design, this study aims to examine the policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure in China. The Propensity Score Matching with Difference-in-difference approach was used to analyse the data obtained from four waves of China Health and Retirement Longitudinal Study (CHARLS). Our findings indicated that, in the aspect of health care utilization, the introduction of LTCI significantly reduced the number of outpatient visits by 0.322 times (p<0.05), the number of hospitalizations by 0.158 times (p<0.01), and the length of inpatient stay during last year by 1.441 days (p<0.01). In the aspect of out-of-pocket health expenditure, we found that LTCI significantly reduced the inpatient out-of-pocket health expenditure during last year by 533.47 yuan (p<0.01), but it did not exhibit an impact on the outpatient out-of-pocket health expenditure during last year. LTCI also had a significantly negative impact on the total out-of-pocket health expenditure by 512.56 yuan. These results are stable in the robustness tests. Considering the evident policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure, the expansion of LTCI could help reduce the needs for health care services and contain the increases in out-of-pocket health care expenditure in China.


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Krystal Warmoth ◽  
Jo Day ◽  
Emma Cockcroft ◽  
Donald Nigel Reed ◽  
Lucy Pollock ◽  
...  

Author(s):  
Tom Dening ◽  
Alisoun Milne

Although only 5% of the total over 65 population in developed countries lives in a care home, the lifetime risk of needing residential care is considerable. In the UK, 418 000 older people occupy nearly 12 000 care homes; the sector has a total value of around £14 billion. Care home residents tend to be very old, most are women, and most have complex co-morbid needs. Most people enter a care home because they can no longer live independently due to ill health, notably dementia. Dementia affects over two thirds of all residents; physical disability and functional impairment are also common. Behavioural disturbance is common as is depression. There are concerns about excessive reliance on medication, and more emphasis recently has been placed on improving standards of care. Evidence suggests that training and good leadership is effective. With the ageing population, the provision and the funding of care home places will come under increasing pressure. The solutions to this are yet to be determined.


2016 ◽  
Vol 32 (12) ◽  
pp. 1371-1380 ◽  
Author(s):  
Gary Cheung ◽  
Siobhan Edwards ◽  
Frederick Sundram

2007 ◽  
Vol 8 (3) ◽  
pp. 141-148 ◽  
Author(s):  
Alice Rota-Bartelink ◽  
Bryan Lipmann

For years, community service providers have been frustrated with the lack in availability of long-term, specialized supported accommodation for older people, particularly older homeless people, with severe acquired brain injury (ABI) and challenging behaviors. Although the incidence of ABI (particularly alcohol-related brain injury) is far wider than being confined to the homeless population, it is frequently misdiagnosed and very often misunderstood. Wintringham is an independent welfare company in Melbourne, Australia, that provides secure, affordable, long-term accommodation and high quality services to older homeless people. The high incidence of alcohol abuse among the resident population has led us to adapt our model of care to accommodate a complexity of need. However, there are some individuals with severely affected behaviors that continue to challenge Wintringham’s capacity to provide adequate support. The deficiency in highly specialized, long-term supported accommodation for older people with severe alcohol-related brain injury (ARBI) is the driving force behind this project. We aim to further develop and improve the current Wintringham model of residential care to better support people with these complex care needs. We will report on the synthesis of this project, which aims to test a specialized model that can be reproduced or adapted by other service providers to improve the life circumstances of these frequently forgotten people.


2008 ◽  
Vol 18 (4) ◽  
pp. 245-256
Author(s):  
Claire C Beeson ◽  
Edmund J Lamb ◽  
Shelagh E O'Riordan

Chronic kidney disease (CKD) refers to long-term impairment of renal function. It is predominantly a disease of older people and the true extent of this has only recently been recognized. CKD has a number of implications including increased cardiovascular risk, secondary complications such as renal anaemia and bone disease and a small but significant risk of progression to established renal failure (ERF). It is associated with significant morbidity, mortality and healthcare costs and, against the background of an ageing population and the rising prevalence of type 2 diabetes, represents a growing public health problem. Evidence that specific interventions can reduce the cardiovascular risk associated with CKD and the risk of progressive CKD, as well as improving quality of life, has highlighted the importance of early detection of this disease.


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