scholarly journals Application of Smart Healthcare in LTCI, Outpatient Mutual-Aid Guarantee Mechanism, and Sustainability of Medical Insurance Fund for Urban Employees

2022 ◽  
Vol 2022 ◽  
pp. 1-10
Author(s):  
Yating Ren ◽  
Zhe Yang

With the aggravation of population aging and the increase of life expectancy, long-term care insurance (LTCI) system has been established to meet the medical and long-term care needs of the increasing elderly population. In China, LTCI system is currently not a stand-alone insurance, but it is attached to the national basic medical insurance fund for urban employees (MIUE). As a result, the expenditure of LTCI is a part of the expenditure of the MIUE, which has an impact on the sustainability of the MIUE. By modeling the income and expenditure of MIUE, especially including the expenditure of LTCI, this study optimized an LTCI system with a higher individual out-of-pocket payment ratio of LTCI and implementation of the outpatient mutual-aid guarantee mechanism (OMAGM), which could improve the sustainability of the MIUE. The study also reveals the following: (i) solely increasing individual out-of-pocket payment ratio of LTCI to 20%–50% can only postpone the deficit on Social Pooling Accounts (SPAs) by 1 or 2 years, and the effect is very limited. (ii) Besides a higher individual out-of-pocket payment ratio, further implementation of a partial OMAGM from 2022 will postpone the deficit on SPAs by 7–9 years, and the implementation of a complete OMAGM from 2022 will postpone the deficit by 14–18 years. Accordingly, China should implement OMAGM as soon as possible to enhance the solvency of MIUE fund, and, in the long run, an independent LTCI scheme should be established to ensure the stability and sustainability of the LTCI fund and the MIUE fund.

Author(s):  
John Giles ◽  
Elena Glinskaya ◽  
Yaohui Zhao ◽  
Xinxin Chen ◽  
Yuqing Hu

2019 ◽  
Vol 34 (10) ◽  
pp. 792-799 ◽  
Author(s):  
Pablo Villalobos Dintrans

Abstract Population aging is driving a process of increase in long-term care needs in Chile and many countries around the world. In this context, this article asks about the consequences of this increase in informal caregivers, emphasizing the inequity issues arising from these changes. Using the CASEN 2017 survey, caregivers are identified and matched to people with long-term care needs. Results show that most caregivers are women, and a large fraction of them are also elderly; this is similar to what has been found previously in developed countries. Caregivers have fewer opportunities than non-caregivers, which translates into lower income-generating ability and higher poverty. The nature of these tasks creates a vicious cycle in which people get trapped with increasing needs and fewer resources to meet them. Important differences arise between caregivers and the rest of the population. Even more concerning is that these disparities are avoidable to some extent, adding an equity dimension to the problem. This emphasizes the need for the generation of policies that will support caregivers and meet their needs.


2018 ◽  
Vol 30 (10) ◽  
pp. 1516-1535 ◽  
Author(s):  
John Knodel ◽  
Bussarawan Teerawichitchainan ◽  
Wiraporn Pothisiri

Objective: To provide a situation analysis of recent long-term care (LTC) needs among older persons in Thailand. Method: The 2014 Survey of Older Persons in Thailand (SOPT) provides data to assess patterns of caregiving, whether care needs are met, and who are main caregivers for older Thais. We examine how types of familial and nonfamilial caregivers are associated with the well-being of older persons. Results: The need for LTC increases sharply with age and is more common among women than men. Spouses and children constitute approximately 90% of main caregivers. The association of a family member as the main caregiver and education or value of assets is quite weak underscoring the general normative prescription for family members to serve as care providers. Discussion: Thailand is experiencing acute population aging but empirical evidence to support LTC needs remains lacking. This analysis helps close the gap.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S801-S801
Author(s):  
Yan Lin ◽  
Edward A Miller ◽  
Marc A Cohen ◽  
Pamela Nadash ◽  
Peng Du

Abstract China is now making all the efforts to solve the problem of who pays the bill for the rapidly increasing long-term care services. Since 2016, 15 cities in China have begun their pilot programs in long-term care insurance. Each city designed its own program. Some cities finance their long-term care services from medical insurance funding solely. Others supplement it with individual and/or employer contributions. This study documents the nature and extent of implementation of long-term care insurance across the 15 pilot cities to draw lessons for subsequent implementation nationally. This study used qualitative methods, including document review and key informant interviews with long-term care insurance administrators, medical insurance administrators, service providers in different settings and families and individuals who use long-term care services. Results reveal considerable variation in the specific attributes of the long-term care insurance programs implemented across the 15 participating cities, with respect to such characteristics as the target population, policy coverage, and payment methods, etc. Results also shed light on the achievements and challenges in implementing the long-term care insurance program. This study’s examination of long-term care insurance adoption in 15 Chinese cities serves as an important base with which to inform future national long-term care insurance design and implementation. It suggests that successful adoption of long-term care insurance across China will require administering jurisdictions to anticipate and address policy bottlenecks and implementation barriers that might otherwise inhibit program impact and effectiveness in addressing the growing long-term care needs of China’s aging population.


2007 ◽  
Vol 8 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Hong Zhang

The combined effects of more and more elderly Chinese living in empty-nest households and into advanced age pose an unprecedented challenge to the traditional family care for the aged in China and raise concerns about how to provide long-term care for the needy elderly. It has been increasingly recognized that the traditional family-based support system alone is inadequate to cope with rapid social change and population aging in China and that there is an urgent need to explore and develop the role of extrafamilial involvement in meeting the needs of long-term care for the Chinese elderly. This study used the interview data collected in 2001 in the city of Wuhan, and three other surveys on eldercare in Wuhan between 1998 and 2005, to show what eldercare patterns have emerged to cope with the long-term care needs of the urban elderly. More specifically, it describes and discusses three new eldercare patterns: at-home eldercare (jujia yanglao), community-based eldercare (shequ yanglao), and institutional care (yanglao jigou yanglao).


2020 ◽  
Vol 103 (12) ◽  
pp. 1315-1324

Background: Factors related to long-term care needs have been studied widely, but there is limited research about the influence of health literacy on long-term care needs among the elderly in rural communities where the social context and care environment are uniquely different. Objective: To examine factors influencing long-term care needs among Thai elderly in rural communities. Materials and Methods: The present study used the cross-sectional design. The study sample included 477 elderly persons, who were members of the communities in Nakhon Ratchasima Province. Multi-stage random sampling was used to select participants. They were interviewed using the demographic and health information questionnaire, the Thai Geriatric Depression Scale (TGDS), the health literacy scale of Thai adults and long-term care needs questionnaire. The selected factors examined as independent variables included some demographic factors, depressive symptom, and health literacy. Results: The present study results revealed significant positive relationships existing between long-term care needs with age and depressive symptom, while negative relationships between income and health literacy were reported. A hierarchical multiple regression analysis indicated that four of nine determinants of long-term care needs: age, depressive symptom, health knowledge and understanding, and ability managing their health condition significantly predicted long-term care needs at a level of 18% (R² adjusted=0.18, p<0.001). Conclusion: The present study results showed associations between personal and health literacy factors with long-term care needs. These findings prove that it is vitally important for healthcare professionals to consider the rural elderly’s mental health status and health literacy when providing care and planning treatment. Keywords: Health literacy, Long-term care needs, Rural community


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 725-725
Author(s):  
Yoko Ibuka ◽  
Yui Ohtsu

Abstract Socioeconomic status (SES) is generating considerable interest in terms of health of individuals, but how it is associated with long-term care has not been established yet. We study the relationship between SES and long-term care provision to parents among the Japanese adults using JSTAR. We use the following six measures of SES for the analysis: income, asset, expenditure, living condition, housing condition and education. We find a greater probability of care provision to parents among those in higher SES categories for some SES measures, compared to the lowest category. However, after considering the survival probability of parents, the relationship is reversed and the probability of care provision is found to be greater among lower SES individuals. The association is more pronounced among males. The association is likely to be partly mediated by care needs of parents. These results suggest a higher burden of care disproportionately falls in low SES individuals.


2017 ◽  
Vol 48 (1) ◽  
pp. 128-147 ◽  
Author(s):  
Mårten Lagergren ◽  
Noriko Kurube ◽  
Yasuhiko Saito

Population aging is expected to increase long-term care (LTC) costs in both Japan and Sweden. This study projected LTC costs for 2010 through 2040 for different assumptions of population change, LTC need by age group and gender, and LTC provided per level of need and cost in Japan and Sweden. Population data were taken from the official national forecasts. Needs projections were based on epidemiological data from the Nihon University Japanese Longitudinal Study of Aging and the Swedish Survey of Living Conditions. Data on LTC provision by need and cost were taken from nine Japanese municipalities collected by assessments in the LTC insurance system and from surveys in eight Swedish municipalities. Total initial costs were calibrated to official national figures. Two projections based on two different scenarios were made for each country from 2010 to 2040. The first scenario assumed a constant level of need for LTC by age group and gender, and the other assumed a continuation of the present LTC need trends until 2025. For Japan, this resulted in a projected cost increase of 93% for the one and 80% for the other; for Sweden it was 52% and 24%, respectively. The results reflected differences in population aging and health development.


Author(s):  
Marsha Love ◽  
Felipe Tendick-Matesanz ◽  
Jane Thomason ◽  
Davine Carter ◽  
Myra Glassman ◽  
...  

The home care workforce, already at 2.7 million caregivers, will become the nation’s fastest growing occupation by 2024 as the senior boom generation accelerates the demand for in home services to meet its long-term care needs. The physically challenging work of assisting clients with intimate, essential acts of daily living places home care workers (HCWs) at risk for musculoskeletal disorders (MSDs); yet, HCWs typically receive little formal job training and may lack appropriate assistive devices. In this qualitative pilot study, HCW focus groups described workplace MSD risk factors and identified problem-solving strategies to improve ergonomic conditions. The results revealed that HCWs rely on their behavioral insights, self-styled communications skills and caring demeanor to navigate MSD risks to themselves and increase clients’ physical independence of movement. We suggest changes in employer and government policies to acknowledge HCWs as valued team members in long-term care and to enhance their effectiveness as caregivers.


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