scholarly journals Impact of Informal Care on Health Care Utilization Among Older People in China

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 334-334
Author(s):  
Yixiao Wang
Keyword(s):  
Health Care ◽  
Older People ◽  
Informal Care ◽  
Outpatient Care ◽  
Inpatient Care ◽  
Health Care Expenditures ◽  
Chinese Government ◽  
Term Care ◽  
Variable Approach ◽  
The Impact

Abstract Population aging has become a challenge to long-term care and health care for the society. Using China as a case study, this paper assesses allocative efficiency of resources in informal care and health care, to explore the effectiveness of the policy, i.e., encouraging informal care as a more cost-effective way to reduce public health care spending. Drawing data from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, this study examines the impact of informal care on utilization of health care as well as amount of health care expenditures among older people with functional limitations in China. Using random effects model with instrumental variable approach, our findings suggest that informal care significantly reduces the utilization of health care, primarily by reducing the utilization of outpatient care. However, informal care significantly increases the amount of inpatient care expenditures for inpatient care users. We do not observe significant association between informal care and amount of outpatient care expenditures for outpatient care users. This study highlights a pressing need for the Chinese government to support informal caregivers by taking economic values of informal caregiving into consideration, and to improve efficiency in inpatient care by a more integrated resource allocation mechanism

scholarly journals Does Receiving Informal Care Lead to Better Health Outcomes? Evidence From China Longitudinal Healthy Longevity Survey

2021 ◽  
pp. 016402752110528
Author(s):  
Yixiao Wang ◽  
Wei Yang
Keyword(s):  
Depressive Symptoms ◽  
Older People ◽  
Informal Care ◽  
Fixed Effects ◽  
Population Aging ◽  
Functional Decline ◽  
Chinese Government ◽  
Fixed Effects Model ◽  
Term Care ◽  
Healthy Longevity

Population aging has become a global challenge. Drawing data from Chinese Longitudinal Healthy Longevity Survey 2008, 2011, and 2014, this study examines the effect of informal care receipt on functional limitations and depressive symptoms among older people in China using lagged fixed effects model. Our findings suggest that receiving informal care is significantly associated with a slower functional decline. We also find that this effect varies across different income groups. The protective effect of informal care is more pronounced among older people with higher income compared to those with lower income. We do not observe any significant associations between receiving informal care and depressive symptoms of older people. This study highlights a pressing need for the Chinese government to establish a comprehensive long-term care system.

scholarly journals Formal and Informal Care: An Empirical Bayesian Analysis Using the Two-part Model

2012 ◽  
Vol 15 (2) ◽  
Author(s):  
Juan Du
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Informal Care ◽  
Inpatient Care ◽  
Treatment Effects ◽  
Substitution Effects ◽  
Hospital Inpatient ◽  
Term Care ◽  
Hospital Inpatient Care ◽  
Part Model

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.

scholarly journals Older People Receiving Public Long-Term Care in Relation to Consumption of Medical Health Care and Informal Care

2008 ◽  
Vol 1 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Staffan Karlsson ◽  
Anna-Karin Edberg ◽  
Albert Westergren ◽  
Ingalill Rahm Hallberg
Keyword(s):  
Health Care ◽  
Older People ◽  
Informal Care ◽  
Long Term Care ◽  
Term Care ◽  
Medical Health Care ◽  
Medical Health

Changes in the remuneration system for psychiatric care in Japan

2011 ◽  
Vol 08 (01) ◽  
pp. 16-22
Author(s):  
H. Ito
Keyword(s):  
Health Care ◽  
Outpatient Care ◽  
Inpatient Care ◽  
Health Care Quality ◽  
Psychiatric Care ◽  
Service Providers ◽  
Care Quality ◽  
Major Influence ◽  
Term Care ◽  
Fee Schedule

SummaryJapan’s psychiatric care is reimbursed according to official prices called “national fee schedule,” which is revised once every 2 years. Fee schedule revisions have had a major influence on medical service providers in Japan, where the rate of private health care institutions is high. The increase of acute beds in inpatient care and the fee schedule for outpatient care have been promoted since the 1990’s. As a result, inpatient care has diverged into acute care units and geriatric units focused primarily on long-term care. In addition, outpatient care services have increased dramatically. Under these circumstances, some key challenges faced by Japan’s psychiatric care include poorly defined catchments areas and how to improve the evaluation of health care quality. Furthermore, the degree to which psychiatric care should assume the responsibility of geriatric care in Japan’s super-aging society remains a topic of debate.

scholarly journals Comprehensive home-based care coordination for vulnerable elders with dementia: Maximizing Independence at Home-Plus—Study protocol

2017 ◽  
Vol 20 (4) ◽  
pp. 123-134 ◽  
Author(s):  
Quincy M Samus ◽  
Karen Davis ◽  
Amber Willink ◽  
Betty S Black ◽  
Melissa Reuland ◽  
...  
Keyword(s):  
Health Care ◽  
Care Coordination ◽  
Life Quality ◽  
Health Care Expenditures ◽  
Dementia Care ◽  
Term Care ◽  
Health Care Innovation ◽  
The Impact ◽  
Care Innovation ◽  
At Home

Introduction Despite availability of effective care strategies for dementia, most health care systems are not yet organized or equipped to provide comprehensive family-centered dementia care management. Maximizing Independence at Home-Plus is a promising new model of dementia care coordination being tested in the U.S. through a Health Care Innovation Award funded by the Centers for Medicare and Medicaid Services that may serve as a model to address these delivery gaps, improve outcomes, and lower costs. This report provides an overview of the Health Care Innovation Award aims, study design, and methodology. Methods This is a prospective, quasi-experimental intervention study of 342 community-living Medicare–Medicaid dual eligibles and Medicare-only beneficiaries with dementia in Maryland. Primary analyses will assess the impact of Maximizing Independence at Home-Plus on risk of nursing home long-term care placement, hospitalization, and health care expenditures (Medicare, Medicaid) at 12, 18 (primary end point), and 24 months, compared to a propensity-matched comparison group. Discussion The goals of the Maximizing Independence at Home-Plus model are to improve care coordination, ability to remain at home, and life quality for participants and caregivers, while reducing total costs of care for this vulnerable population. This Health Care Innovation Award project will provide timely information on the impact of Maximizing Independence at Home-Plus care coordination model on a variety of outcomes including effects on Medicaid and Medicare expenditures and service utilization. Participant characteristic data, cost savings, and program delivery costs will be analyzed to develop a risk-adjusted payment model to encourage sustainability and facilitate spread.

Mental health in Berlin

2011 ◽  
Vol 26 (S2) ◽  
pp. 2120-2120
Author(s):  
A. Heinz
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Outpatient Care ◽  
Inpatient Care ◽  
Legal Status ◽  
Outpatient Psychotherapy ◽  
Retirement Funds ◽  
The Individual ◽  
Multimorbid Patients ◽  
The Impact

Berlin is a capital characterized by migration; about 40% of all adolescents have a migratory background. In recent years, mental health care for migrants has received increasing attention, although costs e.g. for translation in hospitals are still not covered by the insurances, and problems of inpatient care for migrants without a legal status remain. In Berlin, psychiatric hospital care is sectorized, and in each sector, a central conference tries to organize outpatient care and facilities. In spite of these efforts, transition between in- and outpatient care often remains complicated, and outpatient psychotherapy care offered by psychologists frequently does not reach the most severely affected patients. Patients suffering from addiction face additional problems, as detoxification is financed by health care insurances, while treatment of the addictive disorder itself is mainly financed by retirement funds, with pervasive problems characterizing the individual patient's shift from one system to the other. So-called “integrated” approaches that link specialized outpatient and inpatient care are currently established by different health care insurances and may help to bridge such gaps. However, the multitude of different offers from competing insurances threatens to fractionize health care, and multimorbid patients may have to select e.g. an insurance with an excellent program for schizophrenia but a badly structured offer for cancer treatment. Multimorbid patients will thus be forced to decide which of their health care problems is most pressing and to neglect other diseases. Research on the impact of these “integrated” health care programs therefore is urgently warranted.

Habituation Theory and Environment-Aging Research: Ennui to Joie De Vivre?

1989 ◽  
Vol 29 (4) ◽  
pp. 241-257 ◽  
Author(s):  
Carolyn Norris-Baker ◽  
Rick J. Scheidt
Keyword(s):  
Older People ◽  
Psychological Control ◽  
Long Term Care ◽  
Aging Research ◽  
Term Care ◽  
Targeted Interventions ◽  
Situational Characteristics ◽  
The Social ◽  
The Impact

Robert Kastenbaum posits that functional aging results in the overadaptation to our own routines and expectations, producing “hyperhabituation,” mental stagnation, and novaphobic response orientations. This article examines the promise and implications of this notion for two areas of environment-aging research: psychological control and environmental comprehension. Possible causal and mediating links between control and habituation are considered, as well as the impact of habituation on environmental perception, cognition, and appraisal. Personal and situational characteristics of older people likely to be at risk for habituated responses are suggested. The article also speculates about individually- and environmentally-targeted interventions which might prevent and/or ameliorate tendencies toward hyperhabituated responses among older people who reside in highly ritualized and constant environments such as long-term care institutions. Interventions subject to future evaluations include modifications for the social, physical, and policy milieux and desensitization of novaphobic responses.

scholarly journals Ageing, limb-loss and military veterans: a systematic review of the literature

2018 ◽  
Vol 39 (8) ◽  
pp. 1582-1610 ◽  
Author(s):  
NICK CADDICK ◽  
HELEN CULLEN ◽  
AMANDA CLARKE ◽  
MATT FOSSEY ◽  
MICHAEL HILL ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Military Service ◽  
Military Veterans ◽  
Limb Loss ◽  
Cochrane Library ◽  
Term Care ◽  
Long Term Impact ◽  
The Impact

ABSTRACTThe impact of losing a limb in military service extends well beyond initial recovery and rehabilitation, with long-term consequences and challenges requiring health-care commitments across the lifecourse. This paper presents a systematic review of the current state of knowledge regarding the long-term impact of ageing and limb-loss in military veterans. Key databases were systematically searched including: ASSIA, CINAHL, Cochrane Library, Medline, Web of Science, PsycArticles/PsychInfo, ProQuest Psychology and ProQuest Sociology Journals, and SPORTSDiscus. Empirical studies which focused on the long-term impact of limb-loss and/or health-care requirements in veterans were included. The search process revealed 30 papers relevant for inclusion. These papers focused broadly on four themes: (a) long-term health outcomes, prosthetics use and quality of life; (b) long-term psycho-social adaptation and coping with limb-loss; (c) disability and identity; and (d) estimating the long-term costs of care and prosthetic provision. Findings present a compelling case for ensuring the long-term care needs and costs of rehabilitation for older limbless veterans are met. A dearth of information on the lived experience of limb-loss and the needs of veterans’ families calls for further research to address these important issues.

scholarly journals Fourth Ageism: Real and Imaginary Old Age

Societies ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 12
Author(s):  
Paul Higgs ◽  
Chris Gilleard
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Social Representations ◽  
Later Life ◽  
Chronological Age ◽  
Biological Parameters ◽  
Term Care ◽  
The Impact ◽  
State Responses

This paper is concerned with the issue of ageism and its salience in current debates about the COVID-19 pandemic. In it, we address the question of how best to interpret the impact that the pandemic has had on the older population. While many feel angry at what they see as discriminatory lock-down practices confining older people to their homes, others are equally concerned by the failure of state responses to protect and preserve the health of older people, especially those receiving long-term care. This contrast in framing ageist responses to the pandemic, we suggest, arises from differing social representations of later life, reflecting the selective foregrounding of third versus fourth age imaginaries. Recognising the tension between social and biological parameters of ageing and its social categorisations, we suggest, may offer a more measured, as well as a less discriminatory, approach to addressing the selective use of chronological age as a line of demarcation within society.

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