Regional OutlookContinental Europe

2021 ◽  
pp. 475-478
Author(s):  
Ellen M. Immergut
Keyword(s):  
The Netherlands ◽  
Private Insurance ◽  
Unmet Need ◽  
Health Financing ◽  
Term Care ◽  
Administrative Practices ◽  
Health Politics ◽  
Health Related ◽  
Key Issues

The Continental Europe regional outlook presents a comparative assessment of the historical development of the healthcare system, health politics, and selected health-related indicators for Austria, Belgium, France, Germany, Luxembourg, the Netherlands, and Switzerland. In terms of health financing, these countries rely on the compulsory contributory insurance and corporatist administrative practices characteristic of Bismarckian health systems, to which the Netherlands and Switzerland have added mandated private insurance. Health outcomes are very positive, with high life expectancy, low infant mortality, and comparatively low levels of health inequality. Unmet need is the lowest in Europe, and satisfaction is among the highest. Since at least 2002, healthcare has tended to be a highly salient issue for Germany and the Netherlands, but not so for Belgium and Luxembourg, the two countries with the highest levels of public satisfaction with the health system. The key issues in Continental Europe have been cost containment, patient rights, and the introduction of long-term care, as well as some discussion of the role of private insurance and the efficiency of corporatist institutions.

Regional Outlook

2021 ◽  
pp. 159-163
Author(s):  
Ellen M. Immergut ◽  
Maria Oskarson
Keyword(s):  
Waiting Times ◽  
Private Insurance ◽  
Unmet Need ◽  
Health Financing ◽  
Political Debate ◽  
Average Life Expectancy ◽  
Health Politics ◽  
Health Related ◽  
Main Barrier

The Nordic countries regional outlook presents a comparative assessment of the historical development of the healthcare system, health politics, and selected health-related indicators for Denmark, Finland, Iceland, Norway, and Sweden. In terms of health financing, the health systems of all five countries are largely tax-financed, though private payments still cover 13 to 20 percent of health expenditures. Health outcomes are excellent throughout the region, with high average life expectancy and relatively low levels of health inequality. Unmet need is lower than in most other regions in Europe; Finland stands out for longer waiting times as the main barrier. Since at least 2002, healthcare has tended to be a highly salient issue in the Nordic region, where the balance between central control and local self-governance and the increasing role of private insurance and provision tend to be the focus of political debate.

Regional OutlookCentral Eastern Europe

2021 ◽  
pp. 679-682
Author(s):  
Tamara Popic
Keyword(s):  
Eastern Europe ◽  
Private Insurance ◽  
Health Sector ◽  
Health Financing ◽  
Health Politics ◽  
The Public ◽  
Central Eastern Europe ◽  
Health Related ◽  
Key Issues ◽  
Central Eastern

The Central Eastern Europe regional outlook presents a comparative assessment of the historical development of the healthcare system, health politics, and selected health-related indicators for the Czech Republic, Hungary, Poland, Slovakia, and Slovenia. In terms of health financing, these countries rely on compulsory contributory insurance, which is complemented with out-of-pocket spending (highest in Poland) and with voluntary private insurance in Slovenia. While health outcomes are steadily improving, there are high levels of health inequalities. Unmet needs vary dramatically across the region, being the highest in Poland and the lowest in Slovenia, which is also reflected in cross-regional differences in satisfaction. Salience of healthcare is lower than in other European regions, but in most countries, it increased during government attempts to introduce market-oriented reforms. The key issues in Central Eastern Europe have been indebtedness of the public health sector and high levels of perceived corruption in Hungary, Slovakia, and Poland, the countries with the lowest satisfaction. As the chapter notes, a hotly debated issue in the region is privatization of the hospital sector, marked by strong public and political opposition.

Regional Outlook

2021 ◽  
pp. 71-74
Author(s):  
Jane Gingrich ◽  
Scott L. Greer
Keyword(s):  
Historical Development ◽  
Waiting Times ◽  
Unmet Need ◽  
Health Financing ◽  
Political Issue ◽  
Health Politics ◽  
The United Kingdom ◽  
Health Related ◽  
The Uk ◽  
Private Financing

The regional outlook for Ireland and the United Kingdom, both liberal market economies characterized by a limited role for the state, presents a brief comparative assessment of the historical development of their healthcare systems, health politics, and selected health-related indicators. The two are quite different in terms of health financing, with the UK’s health system relying on substantially larger tax expenditures and less private financing. Reported unmet need in the UK is therefore largely attributed to waiting times, whereas in Ireland it is mainly due to cost. Notably, reported unmet need is higher in both than it was in 2005. Since at least 2002, healthcare has tended to be a salient political issue in both Ireland and the UK.

Regional Outlook

2021 ◽  
pp. 397-400
Author(s):  
Mare Ainsaar ◽  
Ave Roots
Keyword(s):  
Unmet Need ◽  
Health Financing ◽  
Healthcare Services ◽  
Political Agenda ◽  
The Political ◽  
Health Politics ◽  
Baltic Countries ◽  
Out Of Pocket Payments ◽  
Health Related ◽  
The Baltic

The regional outlook for the Baltic countries presents a comparative assessment of the historical development of the healthcare system, health politics, and selected health-related indicators for Estonia, Latvia, and Lithuania, each of which pursued a different path to establishing a new health system after independence in 1991. In terms of health financing, out-of-pocket payments are relatively high, especially in Latvia and Lithuania. But while, as might be expected, unmet need due to cost is quite high in Latvia, it is rather low in Lithuania. Though the political saliency of healthcare has been rather low in the Baltics, it appears to be moving up the political agenda. High health inequalities, low satisfaction with healthcare services, and access are among the problems that have persisted.

Gaining access to the field in medical ethnography: Reflections on ethical, methodological, and structural challenges in the study of long-term care facilities

2021 ◽  
pp. 136345932098887
Author(s):  
Neta Roitenberg
Keyword(s):  
Long Term Care ◽  
Ethnographic Research ◽  
Term Care ◽  
Medical Institutions ◽  
Care Workers ◽  
Care Facilities ◽  
Key Issues ◽  
Access To The Field ◽  
Medical Ethnography

The article extends the discussion on the challenges in gaining access to the field in medical ethnographic research, focusing on long-term care (LTC) facilities. Medical institutions have been documented to be difficult sites to access. The reference, however, is to the recruitment of patients as informants. The challenges of recruiting practitioners as informants have not been investigated at all. The article presents the key issues that emerged in the process of gaining social access at the sites of two LTC facilities as part of a study on care workers’ identities. The main obstacles encountered during the fieldwork were organizational constraints and negotiating control over the process of recruiting the lower occupational tier of care workers with gatekeepers. The article presents the coping strategies implemented to overcome the ethical and methodological obstacles: continually reassessing the consent and cooperation of participants and developing a rapport with nurse’s aides during interviews.

scholarly journals COVID-19: first long-term care facility outbreak in the Netherlands following cross-border introduction from Germany, March 2020

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitch van Hensbergen ◽  
Casper D. J. den Heijer ◽  
Petra Wolffs ◽  
Volker Hackert ◽  
Henriëtte L. G. ter Waarbeek ◽  
...  
Keyword(s):  
The Netherlands ◽  
Long Term Care ◽  
Care Facility ◽  
Control Measures ◽  
Border Region ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Cross Border

Abstract Background The Dutch province of Limburg borders the German district of Heinsberg, which had a large cluster of COVID-19 cases linked to local carnival activities before any cases were reported in the Netherlands. However, Heinsberg was not included as an area reporting local or community transmission per the national case definition at the time. In early March, two residents from a long-term care facility (LTCF) in Sittard, a Dutch town located in close vicinity to the district of Heinsberg, tested positive for COVID-19. In this study we aimed to determine whether cross-border introduction of the virus took place by analysing the LTCF outbreak in Sittard, both epidemiologically and microbiologically. Methods Surveys and semi-structured oral interviews were conducted with all present LTCF residents by health care workers during regular points of care for information on new or unusual signs and symptoms of disease. Both throat and nasopharyngeal swabs were taken from residents suspect of COVID-19, based on regional criteria, for the detection of SARS-CoV-2 by Real-time Polymerase Chain Reaction. Additionally, whole genome sequencing was performed using a SARS-CoV-2 specific amplicon-based Nanopore sequencing approach. Moreover, twelve random residents were sampled for possible asymptomatic infections. Results Out of 99 residents, 46 got tested for COVID-19. Out of the 46 tested residents, nineteen (41%) tested positive for COVID-19, including 3 asymptomatic residents. CT-values for asymptomatic residents seemed higher compared to symptomatic residents. Eleven samples were sequenced, along with three random samples from COVID-19 patients hospitalized in the regional hospital at the time of the LTCF outbreak. All samples were linked to COVID-19 cases from the cross-border region of Heinsberg, Germany. Conclusions Sequencing combined with epidemiological data was able to virtually prove cross-border transmission at the start of the Dutch COVID-19 epidemic. Our results highlight the need for cross-border collaboration and adjustment of national policy to emerging region-specific needs along borders in order to establish coordinated implementation of infection control measures to limit the spread of COVID-19.

scholarly journals The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 629-629
Author(s):  
Silke Metzelthin ◽  
Sandra Zwakhalen ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Home Care ◽  
Acute Care ◽  
Long Term Care ◽  
Functional Decline ◽  
Term Care ◽  
The Us ◽  
The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

The Economics of Long-Term Care

2013 ◽  
Vol 14 (2) ◽  
pp. 343-375 ◽  
Author(s):  
Luigi Siciliani
Keyword(s):  
Long Term Care ◽  
Private Insurance ◽  
Care Home ◽  
Significant Proportion ◽  
Empirical Work ◽  
The United States ◽  
Ageing Population ◽  
Public Insurance ◽  
Term Care

Abstract Long-term care expenditure is expected to rise, driven by an ageing population. Given that public long-term care expenditure is high in many OECD countries, governments are increasingly concerned about its future growth. This study focuses on three relevant issues. First, we discuss factors that affect the growth of long-term expenditure and its projections. These include demographics, the balance in provision between informal and formal care, whether higher life expectancy translates into higher disability, the interrelation between health and long-term care, and whether long-term care suffers from Baumol’s disease. Second, given that a significant proportion of long-term care expenditure is nursing- and care-home expenditure, we discuss the role of government regulation aimed at ensuring that individuals receive appropriate quality of care in such institutions. We focus in particular on price regulation, competition, and the non-profit sector; these have been the subject of considerable empirical work (mainly in the United States). Third, we discuss the relative merits of public and private insurance. Countries differ greatly in their approach. Some countries have nearly exclusively public insurance but in others this is small. We consider the conditions under which public insurance can overcome the limitations of a private insurance market.

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