scholarly journals Health status, care needs, and assessment for beneficiaries with or without dementia in a public long-term care insurance pilot in Guangzhou, China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jialan Wu ◽  
Siman Chen ◽  
Huangliang Wen ◽  
Yayan Yi ◽  
Xiaoyan Liao
Keyword(s):  
Barthel Index ◽  
Rasch Analysis ◽  
Long Term Care ◽  
Assessment Tool ◽  
Chinese Government ◽  
Care Needs ◽  
Term Care ◽  
Depth Analysis ◽  
Long Term Care Insurance

Abstract Background Chinese government launched a pilot study on public long-term care insurance (LTCI) recently. Guangzhou is one of the fifteen pilot cities, officially started providing LTCI in August 2017. An in-depth analysis of experimental data from the pilot city may provide suggestions for developing a fair and effective LTCI system. This study aimed to evaluate the LTCI pilot by exploring the characteristics and care needs of claimants, and performance of the assessment tool. Methods A retrospective cross-sectional study in which claims data between July 2018 and March 2019 in the Guangzhou pilot was analyzed. LTCI claimants during the study period were included. The care needs were determined based on claimants’ physical function assessed by the Barthel Index and their medical conditions. Rasch analysis was used to explore the performance of the Barthel Index. Results Among 4810 claimants included, 4582 (95.3%) obtained LTCI benefits. Of these beneficiaries, 4357 (95.1%) were ≧ 60 years old, and 791 (17.3%) had dementia. Among 228 (4.7%) unsuccessful claimants, 22 (0.5%) had dementia. The prevalence of stroke was high in beneficiaries with (38.1%) or without dementia (56.6%), as well as in unsuccessful claimants with (40.9%) or without dementia (52.4%). Beneficiaries without dementia needed more support for basic activities of daily living and nursing care than those with dementia, while beneficiaries with dementia were more likely to be institutionalized. Five (22.7%) unsuccessful claimants with dementia and 48 (23.3%) unsuccessful claimants without dementia were disabled in at least two basic self-care activities. Regarding Barthel Index, Rasch analysis showed threshold disordering in “mobility” and “climbing stairs”, and the narrow interval was observed between all the adjacent categories of the ten items (< 1.4 logits). Conclusions Stroke and dementia were two common reasons for needing long-term care in LTCI claimants. The Barthel Index is not suitable for assessing and dividing LTCI claimants, because of inappropriate items and narrow category responses. A comprehensive assessment and grading system is required, together with needs-led care services. The eligibility should be expanded gradually based on balance finance solutions.

scholarly journals Trends in Life Expectancy With Care Needs Based on Long-term Care Insurance Data in Japan

2012 ◽  
Vol 22 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Rumi Seko ◽  
Shuji Hashimoto ◽  
Miyuki Kawado ◽  
Yoshitaka Murakami ◽  
Masayuki Hayashi ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Long Term Care Insurance ◽  
Insurance Data

Determinants of long-term care insurance applications in South Korea

2020 ◽  
Author(s):  
Sunhee Park ◽  
Heejung Kim ◽  
Chang Gi Park
Keyword(s):  
Older Adults ◽  
South Korea ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Needs ◽  
Term Care ◽  
Factors Affecting ◽  
Long Term Care Insurance ◽  
The Government

Abstract Background South Korea established universal long-term care insurance (LTCI) in 2008. However, actual requests for LTCI remain lower than government estimates because some eligible candidates never apply despite their strong care needs. This study aimed to examine factors affecting LTCI applications for older, community-dwelling Koreans. Methods Both individual- and community-level data were obtained from a national dataset from the Korea Health Panel Survey and the Korea National Statistical Office (N = 523). Data were analyzed using multilevel modeling. Results Only 16.4% of older adults in need of care applied for LTCI. Those who applied were more likely to be older, report poor self-rated health, receive care from non-family caregivers, and have caregivers experiencing high levels of caregiving burden. Regional differences in LTCI applications existed concerning the financial condition of one’s community. Conclusions Our study findings emphasize that Korean LTCI should implement both individual and community strategies to better assist older adults in properly acquiring LTCI. The government should make comprehensive efforts to increase access to LTCI in terms of availability, quality, cost, and information by collaborating with local centers.

Long-Term Care

2018 ◽  
Author(s):  
Pierre Pestieau ◽  
Mathieu Lefebvre
Keyword(s):  
Social Insurance ◽  
Long Term Care ◽  
Private Insurance ◽  
Care Needs ◽  
Term Care ◽  
The Family ◽  
Two Factors ◽  
Long Term Care Insurance

This chapter is concerned with the rise in long-term care needs. Long-term care concerns individuals who are no longer able to carry out basic daily activities. Most of the care is currently provided by informal caregivers, mainly the family, while the role of formal care provided by the state or the market remains small. The chapter explains, however, why informal care is expected to decline and analyses the low private insurance development, the so-called long-term care insurance puzzle. These two factors, the decreasing role of the family and a thin insurance market, plead for the development of a full fledge social insurance for long-term care. The chapter then looks at the optimal design of such an insurance.

scholarly journals Effect of short-stay service use on stay-at-home duration for elderly with certified care needs: Analysis of long-term care insurance claims data in Japan

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0203112 ◽  
Author(s):  
Yoko Moriyama ◽  
Nanako Tamiya ◽  
Akira Kawamura ◽  
Thomas D. Mayers ◽  
Haruko Noguchi ◽  
...  
Keyword(s):  
Service Use ◽  
Long Term Care ◽  
Claims Data ◽  
Needs Analysis ◽  
Short Stay ◽  
Care Needs ◽  
Term Care ◽  
Insurance Claims Data ◽  
Long Term Care Insurance

scholarly journals Range in systolic blood pressure and care-needs certification in long-term care insurance in community-dwelling older patients with chronic kidney disease

2017 ◽  
Vol 46 (1) ◽  
pp. 293-306 ◽  
Author(s):  
Taroh Himeno ◽  
Tazuo Okuno ◽  
Keisuke Watanabe ◽  
Kumie Nakajima ◽  
Osamu Iritani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Older Patients ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Needs ◽  
Term Care ◽  
Long Term Care Insurance ◽  
Older Subjects

Objective Low systolic blood pressure (SBP) is associated with an increased risk for cardiovascular morbidity/mortality in older patients with chronic kidney disease (CKD). The present study evaluated the association between range in blood pressure and first care-needs certification in the Long-term Care Insurance (LTCI) system or death in community-dwelling older subjects with or without CKD. Methods CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2 or dipstick proteinuria of + or greater. Our study was conducted in 1078 older subjects aged 65–94 years. Associations were estimated using the Cox proportional hazards model. Results During 5 years of follow-up, 135 first certifications and 53 deaths occurred. Among patients with CKD, moderate SBP (130–159 mmHg) was associated with a significantly lower adjusted risk of subsequent total certification (hazard ratio [HR] = 0.44) and subsequent certification owing to dementia (HR = 0.17) compared with SBP < 130 mmHg. These relationships were not observed in non-CKD subjects. Conclusion Lower SBP of <130 mmHg may predict a higher risk for subsequent first care-needs certification in LTCI, especially for dementia, in community-dwelling patients with CKD.

scholarly journals Long-Term Care Insurance: Information Frictions and Selection

2020 ◽  
Vol 12 (3) ◽  
pp. 134-169
Author(s):  
M. Martin Boyer ◽  
Philippe De Donder ◽  
Claude Fluet ◽  
Marie-Louise Leroux ◽  
Pierre-Carl Michaud
Keyword(s):  
Long Term Care ◽  
Survey Design ◽  
Financial Risks ◽  
Stated Choice ◽  
Information Frictions ◽  
Care Needs ◽  
Term Care ◽  
Welfare Losses ◽  
Long Term Care Insurance

This paper conducts a stated-choice experiment where respondents are asked to rate various insurance products aimed to protect against financial risks associated with long-term care needs. Using exogenous variation in prices from the survey design and individual cost estimates, these stated-choice probabilities are used to predict market equilibrium for long-term care insurance. Our results are twofold. First, information frictions are pervasive. Second, measuring the welfare losses associated with frictions in a framework that also allows for selection, it is found that information frictions reduce equilibrium take-up and lead to large welfare losses, while selection plays little role. (JEL D82, D83, G22, I13)

Correlation between the Barthel Index and care need levels in the Japanese long‐term care insurance system

2019 ◽  
Vol 19 (11) ◽  
pp. 1186-1187 ◽  
Author(s):  
Tomoyuki Matsuda ◽  
Masao Iwagami ◽  
Toshiki Suzuki ◽  
Xueying Jin ◽  
Taeko Watanabe ◽  
...  
Keyword(s):  
Barthel Index ◽  
Long Term Care ◽  
Term Care ◽  
Insurance System ◽  
Long Term Care Insurance

scholarly journals LONG-TERM CARE IV A REVIEW OF THE LONG-TERM CARE INSURANCE PROGRAMS IN 15 PILOT CITIES IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S801-S801
Author(s):  
Yan Lin ◽  
Edward A Miller ◽  
Marc A Cohen ◽  
Pamela Nadash ◽  
Peng Du
Keyword(s):  
Long Term Care ◽  
Service Providers ◽  
Population Policy ◽  
Medical Insurance ◽  
Implementation Barriers ◽  
Care Needs ◽  
Term Care ◽  
Care Services ◽  
Long Term Care Insurance

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.

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