Long-term care in Spain: a reform failure or the regulation of a development path?

2020 ◽  
Vol 40 (11/12) ◽  
pp. 1301-1317
Author(s):  
Manuel Aguilar-Hendrickson
Keyword(s):  
Long Term Care ◽  
Social Care ◽  
Baby Boom ◽  
Reform Process ◽  
Governance Arrangement ◽  
Term Care ◽  
Content Type ◽  
Care Services ◽  
The Impact

PurposeSpain departed from the Southern European tradition of residual long-term care services with the 2006 reform. The paper aims to present the main traits of the reform and its implementation, explores the reasons that may explain why the reform happened and to which extent and why it fell short of expectations.Design/methodology/approachThe article draws on available literature on the reform and on administrative data to present a complex and nuanced view of the reform process and its limits.FindingsThe reform was actually a measure to enhance and rationalize a preexisting process of social care services development, rather than the creation of a completely new care system. A rapid increase in female labor market participation since the 1990s and the looming demands of a late baby-boom and the subsequent fertility crash appear to be two key factors that explain both the previous development and its bolstering by the reform. The budgetary constraints of the Great Recession and governance problems, linked to a complex and sometimes dysfunctional multilevel governance arrangement, help to understand why the reform bogged down. Nevertheless, the overall balance is more nuanced, and significantly more services are provided 12 years after the reform.Originality/valueWhile many assessments of the reform have been negative, putting it into a larger context of social care development, the 2006 Dependency Act has contributed to a significant increase in expenditure and coverage. The impact of budgetary restrictions has been important, but other factors, such as governance arrangements, may explain more of the problems of the implementation.

scholarly journals Why the Discretion Mix Matters: Understanding the Transformation of Long-term Care Services

2019 ◽  
Vol 56 ◽  
pp. 004695801987182
Author(s):  
Young Jun Choi ◽  
Hyejin Choi
Keyword(s):  
Long Term Care ◽  
Social Care ◽  
Implementation Process ◽  
Theoretical Concept ◽  
Care Provision ◽  
Term Care ◽  
Study Approach ◽  
Care Services

This study aims to extend the concept of discretion, ie, a certain degree of freedom in crucial decisions left to specific actors, to understand and examine the transformation of social care services in the era of aging and austerity. Although previous studies have reviewed and analyzed changes in care provision, they have been less concerned with who has the authority to make care decisions in the implementation process. We propose a new theoretical concept, the discretion mix, to understand the realignment of social care services beyond simply tracking institutional changes. Using a case study approach, this research investigates how the discretion mix of the Korean long-term care system has changed and the consequences of these changes; in addition, it discusses why the discretion mix can be a useful concept for analyzing the changing landscape of social care services.

scholarly journals Ethnicity at work: the case of British minority workers in the long-term care sector

2014 ◽  
Vol 33 (2) ◽  
pp. 177-192 ◽  
Author(s):  
Shereen Hussein ◽  
Jill Manthorpe ◽  
Mohamed Ismail
Keyword(s):  
Migrant Workers ◽  
Long Term Care ◽  
Social Care ◽  
Local Area ◽  
Care Work ◽  
European Economic Area ◽  
Term Care ◽  
Data Set ◽  
Content Type

Purpose – The aim of this paper is to explore the effect of ethnicity and separate this from the other dynamics associated with migration among members of the long-term care workforce in England focusing on the nature and structure of their jobs. The analysis examines interactions between ethnicity, gender, and age, and their relations with “meso” factors related to job and organizational characteristics and “macro” level factors related to local area characteristics. Design/methodology/approach – The paper analyses new national workforce data, the National Minimum Data Set for Social Care (NMDS-SC), n=357,869. The paper employs descriptive statistical analysis and a set of logistic regression models. Findings – The results indicate that labour participation of British black and minority ethnic (BME) groups in long-term care work is much lower than previously believed. There are variations in nature of work and possibly job security by ethnicity. Research limitations/implications – While the national sample is large, the data were not purposively collected to examine differentials in reasons to work in the care sector by different ethnicity. Practical implications – The analysis highlights the potential to actively promote social care work among British BME groups to meet workforce shortages, especially at a time where immigration policies are restricting the recruitment of non-European Economic Area nationals. Originality/value – The analysis provides a unique insight into the participation of British BME workers in the long-term care sector, separate from that of migrant workers.

scholarly journals Mass evacuation and increases in long-term care benefits: lessons from the Fukushima nuclear disaster

2019 ◽  
Author(s):  
Tomohiro Morita ◽  
Michihito Ando ◽  
Yui Ohtsu
Keyword(s):  
Long Term Care ◽  
Elderly Individual ◽  
Term Care ◽  
Care Level ◽  
Nuclear Disaster ◽  
Care Services ◽  
Fukushima Nuclear Disaster ◽  
Mass Evacuation ◽  
The Impact

AbstractBackgroundThough mass evacuation may increase the need for long-term care (LTC) services, how the need for LTC services increases and how the public LTC system affects it is not well understood. We evaluated changes in public LTC benefits for the people living in the mandatory evacuation areas established after the 2011 Fukushima nuclear disaster and examined the roles of the universal LTC insurance system in Japan.MethodsIn order to evaluate the effect of the mandatory evacuation on LTC benefits, we examined the trends of LTC benefits in the Fukushima evacuation group and the nationwide non-evacuation group. We first decomposed per-elderly-individual benefits at the municipality level into the LTC certification rate and per-certified-individual benefits, and then implemented difference-in-differences analysis using these variables as outcomes.ResultsPer-elderly-individual benefits significantly increased from 2012 onward in the evacuation group, and this was explained by an increase in the certification rate rather than in per-certified-individual benefits. Increases in per-elderly-individual benefits and the certification rate in the post-disaster period were observed in all but the highest care level, and the corresponding outcomes for the highest care level decreased immediately after the disaster. We also found that the increase in the certification rate had been mostly realized by an increase in the number of certified individuals.ConclusionsThe increase in LTC benefits can be associated with the impact of the increase in the number of people newly certified to receive LTC benefits after the mandatory evacuation. In order to cope with the increase in utilization of long-term care and associated costs after disasters in aging societies, both formal long-term care services and social support for informal care for evacuees should be considered important.

scholarly journals Policies of Personalisation in Norway and England: On the Impact of Political Context

2014 ◽  
Vol 43 (3) ◽  
pp. 479-496 ◽  
Author(s):  
KAREN CHRISTENSEN ◽  
DORIA PILLING
Keyword(s):  
Care Provider ◽  
Long Term Care ◽  
Welfare States ◽  
Ageing Population ◽  
Disabled People ◽  
Term Care ◽  
Care Services ◽  
And Control ◽  
The Impact

AbstractWithin Europe, the Norwegian and English welfare states represent two different welfare regimes. Due to common demographic challenges of an ageing population as well as grass- roots pressures, particularly from disabled people, significant changes in the delivery of long-term care services for older and disabled people have taken place. This article focuses on the change towards personalisation policies encouraging greater choice and control in regard to care services, and uses the case of ‘cash-for-care’, which gives people an allocation of funding to meet their needs, to discuss conditions and implications of personalisation policies within different contexts. Based on a theoretical framework exploring a democratic and a market discourse of personalisation policies, the article provides a comparative analysis of the Norwegian and English cash-for-care schemes. While a crucial common change in the public sector's role towards at-arm’s-length long-term care services occurred, significant differences remain: while English residents are given greater choice and control from the beginning of the allocation of cash-for-care they also face more insecure circumstances due to the simultaneously stimulated care provider market. The Norwegian case, however, shows a possibility of increasing choice and control without a large diversity in a care provider market.

Modelling ageing populations to 2030: financing long-term care in England

2018 ◽  
Author(s):  
Michael Murphy ◽  
Ruth Hancock ◽  
Raphael Wittenberg ◽  
Bo Hu ◽  
Marcello Morciano ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Public And Private ◽  
Care Services ◽  
Private Expenditure ◽  
The Impact ◽  
Care Costs

This chapter presents some findings from the research project ‘Modelling Needs and Resources of Older People to 2030’ (MAP2030). The project developed a set of projection models to estimate future family circumstances, incomes, pensions, savings, disability and care needs of older people in England. These projections included public and private expenditure on pensions, disability benefits and care services under different scenarios for reform of pensions and long-term care funding under a range of alternative population futures. The chapter focuses on the projected future costs and impacts for the different income quintiles of the older population of proposed reforms to the system of funding adult social care, in particular the impact of a cap on individual liability to meet care costs.

Access to long-term care: perceptions and experiences of older Dutch people

2015 ◽  
Vol 16 (2) ◽  
pp. 83-93 ◽  
Author(s):  
Lisette Schipper ◽  
Katrien G. Luijkx ◽  
Bert R. Meijboom ◽  
René Schalk ◽  
Jos M.G.A. Schols
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Term Care ◽  
Content Type ◽  
Care Access ◽  
Care Services ◽  
Significant Difference ◽  
Access Service ◽  
The Difference

Purpose – Despite the current focus on demand-based care, little is known about what clients consider important when they have a request for formal long-term care services. The paper aims to discuss this issue. Design/methodology/approach – Questions about the access process to care services were added to the “Senior Barometer”, a Dutch web-based questionnaire that assesses the opinion of older people about different aspects in life. The questionnaire surveyed both people who already requested care services (“users”), and people that did not (“future clients”). Findings – The results show a significant difference in what people expect to be the first step from what users actually did, when requesting formal care services. In addition, there was a significant difference on how “users” and “future clients” rated several access service aspects. Research limitations/implications – The results give valuable information on how both “users” and “future clients” value the access process. The findings also provide valuable input for organizations providing long-term care for older clients about the important issues that have to be considered when organizing the access process. Originality/value – This study shows what older people in the Netherlands find important during the access process to care and this has not been explored before. The difference between what “users” and “future clients” find of importance in the care access process suggests that it is difficult for people to foresee what will be important once the need for care arrives, or where they will turn to with a request for care services.

Implementing Consumer Choice in Long-term Care: The Impact of Individual Budgets on Social Care Providers in England

2011 ◽  
pp. no-no ◽  
Author(s):  
Mark Wilberforce ◽  
Caroline Glendinning ◽  
David Challis ◽  
Jose-Luis Fernandez ◽  
Sally Jacobs ◽  
...  
Keyword(s):  
Consumer Choice ◽  
Long Term Care ◽  
Social Care ◽  
Care Providers ◽  
Term Care ◽  
The Impact

Improving long-term care services: insights from high-reliability organizations

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Maryam Memar Zadeh ◽  
Nicole Haggerty
Keyword(s):  
Management Practices ◽  
Long Term Care ◽  
High Reliability ◽  
High Reliability Organizations ◽  
Term Care ◽  
Traditional Management ◽  
Content Type ◽  
Care Services ◽  
Management Approaches

Purpose Long-term care (LTC) organizations have struggled to protect their vulnerable clients from the ravages of the COVID-19 pandemic. Although various suggestions on containing outbreaks in LTC facilities have gained prominence, ensuring the safety of residents is not just a crisis issue. In that context, the authors must reasses the traditional management practices that were not sufficient for handling unexpected and demanding conditions. The purpose of this paper is to suggest rethinking the underlying attributes of LTC organizations and drawing insight from the parallels they have to high-reliability organizations (HROs). Design/methodology/approach The authors analyzed qualitative data collected from a Canadian LTC facility to shed light on the current state of reliability practices and culture of the LTC industry and to identify the strengths and weaknesses of the traditional management approaches. Findings To help the LTC industry develop the necessary crisis management capacity to tackle unexpected future challenges, there is an urgent need for adopting a more systemic top-down approach that cultivates mindfulness, learning and resilience. Originality/value This study contributes by applying the HRO theoretical lens in the LTC context. The study provides the LTC leaders with insights into creating a unified effort at the industry level to give rise to a high-reliability-oriented industry.

Exploring the Impact of the Japanese Long-Term Care Insurance Act on the Gendered Stratification of the Care Labour Market Through an Analysis of the Domiciliary Care Provided by Welfare Non-Profit Organisations

2011 ◽  
Vol 10 (4) ◽  
pp. 433-443 ◽  
Author(s):  
Junko Yamashita
Keyword(s):  
Long Term Care ◽  
Process Of Care ◽  
Term Care ◽  
Unequal Distribution ◽  
Non Profit ◽  
Care Services ◽  
Restructuring Process ◽  
Long Term Care Insurance ◽  
The Impact

Japan's implementation of the Long Term Care Insurance Act in 2000 provides a good example with which to examine the restructuring process of care services for older people, as these have come to be commodified by the welfare state. By focusing on Welfare Non-Profit Organisations provision, this article explores the significance of gender in the restructuring process. It reveals that care services are stratified with institutional care placed at the top of hierarchy of care services costs, and domestic task services at the bottom. There is an unequal distribution of gender and organisational type for each type of care work.

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