Use of public health and social care services among the elderly in Finland: An under-examined mechanism of redistribution

2019 ◽  
Vol 30 (2) ◽  
pp. 176-189 ◽  
Author(s):  
Maria Vaalavuo

The opportunity to use public services supports older people’s livelihoods, although out-of-pocket fees can be a burden, especially for low-income pensioners. In this article, we analyse the use of health and social care services among the elderly in Finland. The objectives are two-fold: first, to study the distribution of public spending on services across income groups, and second, to investigate the related costs to the service-user. The article contributes to the debate on the welfare states’ redistributive function. The study is based on register data covering the total Finnish population in 2015. In our descriptive analysis, we focus on the distribution of the cost of production (based on detailed unit costs), user fees (calculated based on legislation) as well as reimbursements by social insurance and out-of-pocket payments for medicine, private services and travel costs. The results show that the amount of in-kind benefits is the largest in the two bottom income quintiles both in absolute and relative terms. We also see that the related costs to the client are small in relation to the monetary value of the service, although they amount to 9% of the disposable income in the lowest income quintile. It is noteworthy that benefits are highly concentrated on a small group of individuals. Public services create an important context for the evaluation of adequacy of cash income. Likewise, when we want to understand economic conditions of elderly people in a more comprehensive way, studying the share of disposable income going to health and social care is one important dimension. However, we also argue that we need to be cautious when making claims about redistribution through public services.

2014 ◽  
Vol 13 (4) ◽  
pp. 563-568
Author(s):  
Rob Wilson ◽  
Susan Baines ◽  
Ian McLoughlin

This themed section has at its heart reflections on the development of policy of, and for, information in health and social care over the last ten years in both the UK and Australia. It addresses a set of concerns often overlooked within social policy, namely the use of information and information systems as tools by organisations, policy makers and practitioners in the modernisation or transformation of public services, including in this case health and social care. Not long ago, in both countries, information was perceived as a panacea for the problems of integrating care services between health and social care organisations and these organisations and the patient, client or user of services. The authors focus upon England and Australia and contrast them briefly with other countries in Europe where the state plays a range of roles in the provision of health and social care.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn Pfaff ◽  
Heather Krohn ◽  
Jamie Crawley ◽  
Michelle Howard ◽  
Pooya Moradian Zadeh ◽  
...  

Abstract Background Vulnerable persons are individuals whose life situations create or exacerbate vulnerabilities, such as low income, housing insecurity and social isolation. Vulnerable people often receive a patchwork of health and social care services that does not appropriately address their needs. The cost of health and social care services escalate when these individuals live without appropriate supports. Compassionate Communities apply a population health theory of practice wherein citizens are mobilized along with health and social care supports to holistically address the needs of persons experiencing vulnerabilities. Aim The purpose of this study was to evaluate the implementation of a compassionate community intervention for vulnerable persons in Windsor Ontario, Canada. Methods This applied qualitative study was informed by the Consolidated Framework for Implementation Research. We collected and analyzed focus group and interview data from 16 program stakeholders: eight program clients, three program coordinators, two case managers from the regional health authority, one administrator from a partnering community program, and two nursing student volunteers in March through June 2018. An iterative analytic process was applied to understand what aspects of the program work where and why. Results The findings suggest that the program acts as a safety net that supports people who are falling through the cracks of the formal care system. The ‘little things’ often had the biggest impact on client well-being and care delivery. The big and little things were achieved through three key processes: taking time, advocating for services and resources, and empowering clients to set personal health goals and make authentic community connections. Conclusion Compassionate Communities can address the holistic, personalized, and client-centred needs of people experiencing homelessness and/or low income and social isolation. Volunteers are often untapped health and social care capital that can be mobilized to promote the health of vulnerable persons. Student volunteers may benefit from experiencing and responding to the needs of a community’s most vulnerable members.


2020 ◽  
Vol 85 ◽  
pp. 02004
Author(s):  
Igor Ljubi ◽  
Hrvoje Belani ◽  
Suzana Belosevic Romac

Among many other services, modern governments offer both healthcare and social care to their citizens. Traditionally built in a silo structure and often using separate funding schemes, these two services offer limited possibilities for integration. Therefore, a novel approach is needed which will enable the integrated provisioning of both social and healthcare services to the citizens. This paper describes a platform for collaboration on multiple levels, provided to connect actors from healthcare and social care services – from primary care medical doctors to hospitals, and from home caregivers and/or family members to emergency centres for the elderly. Utilizing the cloud-based ICT tool, we have developed an integrated e-care model and introduced personalised care pathways for the elderly people suffering from various health problems (including heart failure, cardio-vascular diseases, diabetes and mental health issues). This model employs a patient-centric approach to care delivery, giving the patient (or the person acting on behalf of the patient) in power to control (and to share) any data relevant to treat patient's health condition. For the socio-sanitary care providers the benefit is the ability to influence clinical outcomes by remotely monitor and coordinate care initiatives. Using this approach, government has an effective aid to meet quality thresholds, generate clinical outcome metrics and improve satisfaction of the citizens using health and social care services.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. P. Pomey ◽  
M. de Guise ◽  
M. Desforges ◽  
K. Bouchard ◽  
C. Vialaron ◽  
...  

Abstract Background Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues. Methods/design We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients’ experience of emotional support throughout their care trajectory. Discussion This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.


2020 ◽  
pp. 030802262097394
Author(s):  
Deborah Bullen ◽  
Channine Clarke

Introduction In response to growing demands on health and social care services there is an emphasis on communities addressing the needs of local populations to improve lives and reduce inequalities. Occupational therapists are responding to these demands by expanding their scope of practice into innovative settings, such as working with refugees, the homeless and residents of nursing homes, and within sport and leisure environments. The benefits of sport are widely acknowledged, and this paper argues that occupational therapists could play a pivotal role in enabling people to participate. Method This qualitative study drew on a phenomenological approach and used interviews and thematic analysis to explore five occupational therapists’ experiences of enabling people to participate in sport. Findings Findings revealed that participants demonstrated the uniqueness of occupational therapy when enabling people to participate in sport and practised according to their professional philosophy. There were opportunities to reach wider communities and promote the value of occupational therapy by collaborating with organisations, but there were also challenges when working outside of traditional settings. Conclusion The study emphasises the unique skills occupational therapists can bring to this setting. It highlights opportunities to expand their practice, to forge new partnerships in sports and leisure environments, and to address the national inactivity crisis.


2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.


Author(s):  
Susanna Nordin ◽  
Jodi Sturge ◽  
Maria Ayoub ◽  
Allyson Jones ◽  
Kevin McKee ◽  
...  

Information and communication technology (ICT) can potentially support older adults in making decisions and increase their involvement in decision-making processes. Although the range of technical products has expanded in various areas of society, knowledge is lacking on the influence that ICT has on older adults’ decision-making in everyday situations. Based on the literature, we aimed to provide an overview of the role of ICT in home-dwelling older adults’ decision-making in relation to health, and health and social care services. A scoping review of articles published between 2010 and 2020 was undertaken by searching five electronic databases. Finally, 12 articles using qualitative, quantitative, and mixed-method designs were included. The articles were published in journals representing biology and medicine, nursing, informatics, and computer science. A majority of the articles were published in the last five years, and most articles came from European countries. The results are presented in three categories: (i) form and function of ICT for decision-making, (ii) perceived value and effect of ICT for decision-making, and (iii) factors influencing ICT use for decision-making. According to our findings, ICT for decision-making in relation to health, and health and social care services was more implicitly described than explicitly described, and we conclude that more research on this topic is needed. Future research should engage older adults and health professionals in developing technology based on their needs. Further, factors that influence older adults’ use of ICT should be evaluated to ensure that it is successfully integrated into their daily lives.


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