Substitutional effect of long-term care to hospital inpatient care?

2020 ◽  
Vol 62 ◽  
pp. 101466
Author(s):  
Bei Lu ◽  
Hong Mi ◽  
Gaoyun Yan ◽  
Jonathan K.H. Lim ◽  
Guanggang Feng
2012 ◽  
Vol 15 (2) ◽  
Author(s):  
Juan Du

Abstract Informal care provided to the elderly by their children is proposed as a less expensive alternative to institutional long-term care. This paper explores how the elderly's consumption of medical care changes in response to changes in the informal care they receive from their children. Many earlier studies have ignored both the endogeneity of informal care and the complicated nature of health care utilization data. This paper develops a two-part model with informal care treated as an endogenous regressor and imposes exclusion restrictions on the selection process. The model is fitted using the Bayesian Markov Chain Monte Carlo (MCMC) methods, in particular the Gibbs sampler and the Metropolis-Hasting algorithm. The average treatment effects and the distributions of the treatment effects are obtained via posterior simulation. The results indicate that informal care provides a substitute for nursing home care and hospital inpatient care, but it does not affect paid home health care on average. The treatment effects are heterogeneous. The largest substitution effects occur for nursing home and hospital inpatient care at the intensive margin. The policy analysis suggests that informal care policies targeting the group that incurs the largest substitution effect may help to reduce government spending on Medicaid and Medicare.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 84-84
Author(s):  
Wei Yang

Abstract Publicly funded long-term care (LTC) support is shrinking in many countries despite continuing increases in the number of older people who need care. Evidence has shown that the LTC services have an impact on the efficient use of the resources in the health care sector by reducing rates of admission and associated costs through assisting older people with daily living. This paper seeks to examine whether and to what extent these services are substitutes. We use a fixed-effect instrumental variable GMM model to predict the effect of long-term care services on the utilisation of outpatient and inpatient care services. Data are drawn from China Health and Retirement Longitudinal Survey 2011, 2013 and 2015. Our findings suggest that LTC significantly reduces the use of outpatient care but not inpatient care. We have also found LTC use is concentrated among the rich, but the substitution effects are stronger among the poor compared to the rich. This indicates that the poor would benefit more from subsided LTC services. We urge the Chinese government to take action to develop its formal LTC system and to channel more resources to its LTC system, which will benefit the older population in general, and the poor in particular.


2011 ◽  
Vol 16 (1) ◽  
pp. 18-21
Author(s):  
Sara Joffe

In order to best meet the needs of older residents in long-term care settings, clinicians often develop programs designed to streamline and improve care. However, many individuals are reluctant to embrace change. This article will discuss strategies that the speech-language pathologist (SLP) can use to assess and address the source of resistance to new programs and thereby facilitate optimal outcomes.


2001 ◽  
Vol 10 (1) ◽  
pp. 19-24
Author(s):  
Carol Winchester ◽  
Cathy Pelletier ◽  
Pete Johnson

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.


2002 ◽  
Author(s):  
Maryam Navaie-Waliser ◽  
Aubrey L. Spriggs ◽  
Penny H. Feldman

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