scholarly journals Participatory approach in developing the long-term care strategy in Slovakia

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Z Katreniakova ◽  
M Levyova ◽  
M Giertl ◽  
I Nagyova

Abstract Issue/problem In Slovak Republic (SR) old-age dependency will rise rapidly in the near future and will more than double in the next 15 years. This profound demographic changes will require restructuring of health and social care systems with more people working in the long-term care (LTC) sector and most likely a higher level of public spending to cover the growing LTC needs. Description of the problem Providing LTC in Slovakia has many problem areas. It is governed by several acts and regulations, which are not always linked and sometimes do not cover the situation entirely. There is not coordinated and integrated LTC model implemented and the distribution of the roles between the health and social care systems is lacking. Results Since 2017 a policy dialog between the key stakeholders - the Ministry of Health of the SR; the Ministry of Labour, Social Affairs and Family of the SR; and civic societies led by the Association for the Patients’ Rights Protection has been in place with aim to improve the current LTC Strategy Proposal. Online survey was carried out in May - June 2018, which brought deeper insights into the needs regarding demand and supply, and uncovered the main limitations of the current LTC system, e.g. insufficient capacity of LTC beds or a malfunctioning information system. This was followed by six workshops for professional and lay public, organised between February and March 2019 with aim to collect further evidence on regional level. Lessons The LTC Strategy Proposal development is one of 12 pilot projects within the national project - Promoting partnership and dialogue on participatory public policy making in SR. The initiative takes into account the needs and demands of LTC target groups and will serve as a starting point for further action in this area. [Grant Support: APVV-15-0719]. Key messages In Slovakia, a complex solution of long-term care issues is essential. Developing the LTC Strategy Proposal through participatory approach is an important starting point for future action.

2014 ◽  
Vol 23 (01) ◽  
pp. 1440005 ◽  
Author(s):  
Francisco Grimaldo ◽  
Juan M. Orduña ◽  
Miguel Lozano ◽  
Francisco Ródenas ◽  
Jorge Garcés

In this paper, we propose a simulator for integrated long-term care systems using as a starting point a holistic model of care systems for people that need long term care, the Sustainable Socio-Health Model (SSHM). The implementation of the simulator on the Jason multi-agent platform allows the tool to include the human interactions, preferences, and social abilities that take place between elderly people and the staff of healthcare systems (doctors, social workers and nurses). In addition, the use of this multi-agent platform provides the required scalability for simulating population sizes of different orders of magnitude. The paper shows the model to be implemented in the simulator, the simulator architecture, the types of agents considered, their functionality and the information flow among them. Additionally, it shows the validation of the simulator with real data obtained from empirical studies conducted by the Polibienestar Research Institute in Spain, as well as a performance evaluation that sketches the performance of the simulator when using the centralized Jason infrastructure under different population sizes. Effectively, simulation can provide policy makers with the option of going into a decision theatre and virtually knowing the consequences of different policies prior to determining the real policy to be adopted.


Author(s):  
Tamara Daly

ABSTRACTThe paper discusses two reforms in Ontario's long-term care. The first is the commercialization of home care as a result of the implementation of a “managed competition” delivery model. The second is the Ministry of Health and Long-Term Care's privileging of “health care” over “social care” through changes to which types of home care and home support services receive public funding. It addresses the effects of these reforms on the state–non-profit relationship, and the shifting balance between public funding of health and social care. At a program level, and with few exceptions, homemaking services have been cut from home care, and home support services are more medicalized. With these changes, growing numbers of people no longer eligible to receive publicly funded home care services look for other alternatives: they draw available resources from home support, they draw on family and friend networks, they hire privately and pay out of pocket, they leave home and enter an institution, or they do without.


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