Health Care Use Before and After Entering Long-Term Services and Supports

2016 ◽  
Vol 37 (1) ◽  
pp. 26-40 ◽  
Author(s):  
Robert Newcomer ◽  
Charlene Harrington ◽  
Denis Hulett ◽  
Taewoon Kang ◽  
Michelle Ko ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Long Term Care ◽  
Health Care Use ◽  
Care Providers ◽  
Term Care ◽  
Before And After ◽  
Ed Visits ◽  
Post Acute Care

Objective: We examined the health care utilization patterns of Medicare and Medicaid enrollees (MMEs) before and after initiating long-term care in the community or after admission to a nursing facility (NF). Method: We used administrative data to compare hospitalizations, emergency department (ED) visits, and post-acute care use of MMEs receiving long-term care in California in 2006-2007. Results: MMEs admitted to a NF for long-term care had much greater use of hospitalizations, ED visits, and post-acute care before initiating long-term care than those entering long-term care in the community. Post-entry, community service users had less than half the average monthly hospital and ED use compared with the NF cohort. Conclusion: Hospital and ED use prior to and following NF and personal care program entry suggest a need for reassessing the monitoring of these high-risk populations and the communication between health and community care providers.

Pay-for-Performance and Long-Term Care

2019 ◽  
Author(s):  
Jun Li ◽  
Edward C. Norton
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Long Term Care ◽  
Pay For Performance ◽  
Care Delivery ◽  
The United States ◽  
Future Research ◽  
Care Providers ◽  
Term Care

Pay-for-performance programs have become a prominent supply-side intervention to improve quality and decrease spending in health care, touching upon long-term care, acute care, and outpatient care. Pay-for-performance directly targets long-term care, with programs in nursing homes and home health. Indirectly, pay-for-performance programs targeting acute care settings affect clinical practice for long-term care providers through incentives for collaboration across settings. As a whole, pay-for-performance programs entail the identification of problems it seeks to solve, measurement of the dimensions it seeks to incentivize, methods to combine and translate performance to incentives, and application of the incentives to reward performance. For the long-term care population, pay-for-performance programs must also heed the unique challenges specific to the sector, such as patients with complex health needs and distinct health trajectories, and be structured to recognize the challenges of incentivizing performance improvement when there are multiple providers and payers involved in the care delivery. Although empirical results indicate modest effectiveness of pay-for-performance in long-term care on improving targeted measures, some research has provided more clarity on the role of pay-for-performance design on the output of the programs, highlighting room for future research. Further, because health care is interconnected, the indirect effects of pay-for-performance programs on long-term care is an underexplored topic. As the scope of pay-for-performance in long-term care expands, both within the United States and internationally, pay-for-performance offers ample opportunities for future research.

scholarly journals Evaluating the Conversation Starter Kit in Long Term Care: A Canadian Perspective

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 944-945
Author(s):  
Sharon Kaasalainen ◽  
Tamara Sussman
Keyword(s):  
Health Care ◽  
Advance Care Planning ◽  
Long Term Care ◽  
Family Members ◽  
Care Planning ◽  
Term Care ◽  
Before And After ◽  
Advance Care ◽  
Planning Intervention

Abstract This study evaluated an advance care planning intervention, the Conversation Starter Kit (CSK) booklet, for use in long term care (LTC) homes. This study used a quasi-experimental, one group pre/post design. Quantitative surveys were administered before and after a 3-month advance care planning intervention (CSK booklet). Data were collected at three LTC homes in southern Ontario. We collected data from 55 resident who were able to make decisions on their own paired with 11 family members of these residents. We also collected data from 24 family members of residents who were not able to make decisions on their own. Quantitative surveys were administered before and after the intervention. An additional structured interview was completed at the end of the intervention period, which included both closed and open-ended questions to assess perceptions about the CSK booklet’s use or non-use. Residents reported higher engagement in advance care planning after having completed the CSK booklet than before, particularly related to asking questions to health care providers about health care decisions. Family members reported feeling very certain that they would be able to make decisions on behalf of the resident but they felt less certain after completing the CSK booklet, implying that the CSK booklet raised their awareness of the types of decisions that they might need to make, hopefully triggering them to become more prepared for these decisions in the future. The CSK appears acceptable, easy to use for residents and family members/friends in LTC, and can improve resident engagement in ACP.

scholarly journals A Health System Response to COVID ‐19 in Long‐Term Care and Post‐Acute Care: A Three‐Phase Approach

2020 ◽  
Vol 68 (6) ◽  
pp. 1155-1161 ◽  
Author(s):  
Gina Kim ◽  
Mengru Wang ◽  
Hanh Pan ◽  
Giana H. Davidson ◽  
Alison C. Roxby ◽  
...  
Keyword(s):  
Health System ◽  
Acute Care ◽  
Long Term Care ◽  
System Response ◽  
Term Care ◽  
Phase Approach ◽  
Three Phase ◽  
Post Acute Care

Health Insurance Systems as Models for Managing the Increasing Elderly Populations of Japan and Korea

2011 ◽  
pp. 282-294
Author(s):  
Seungwon Jeong ◽  
Yusuke Inoue
Keyword(s):  
Health Care ◽  
Social Services ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Medical Facilities ◽  
Before And After ◽  
Long Term Care Insurance ◽  
The Republic

This chapter looks into the systems and institutions for the elderly population covered by long-term care insurance in Japan and the Republic of Korea (hereafter Korea). It shall discuss the historical changes in policies in these two nations. The Health Care and Welfare Complex elements that make up a single business model for the Health Care and Social Services of the aged in Japan and Korea will also be discussed in this paper. The management environment for medical facilities greatly changed with adjustments in the population structure and the social environment, and this resulted in serious competition between medical facilities for patients. Medical facilities in Japan and Korea showed a rapid increase in comprehensive medical and welfare management. Consequently, there were provisions in both health care and social services through affiliation, chain affiliation and multiplication, before and after the enforcement of long-term care insurance.

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