scholarly journals Evaluating the long-term care insurance policy from medical expenses and health security equity perspective: evidence from China

2022 ◽  
Vol 80 (1) ◽  
Author(s):  
Huan Liu ◽  
Tiantian Hu
Keyword(s):  
Low Income ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Health Security ◽  
Medical Expenses ◽  
Measurement Results ◽  
Adl Disability ◽  
Hospital Expenses

Abstract Background Since the national long-term care (LTCI) policy pilot in 2016 of China, the LTCI policy has had significant impact on the residents in the pilot area. Methods From the perspective of medical expenses and health security equity, this study selects tracking survey data from the CHARLS database in 2013, 2015, and 2018 and empirically investigates the effect of LTCI policy pilot by using differences-in-differences method (DID). Moreover, this study measures the economic distribution and health equity of the treated and untreated groups using the concentration and Theil indices. Results The results showed that group heterogeneity of medical expenses and health level of elderly in the treatment group were narrowing. Moreover, the policy results showed that the LTCI policy pilot significantly affects the outpatient, hospital expenses, and length of stay of elders. Residence registration, income level, and basic medical insurance play a significant regulatory role. Additionally, LTCI policy pilot significantly improved the overall health of the elderly. Conclusions The measurement results of inequality show that the policy increases the income of low-income people, lowers the inequality level of outpatient and inpatient reimbursement, and reduces the concentration index of ADL disability and serious diseases. However, the inequality of serious diseases is becoming higher. Based on this, this paper provides several suggestions on optimizing the pilot policy of LTCI.

scholarly journals Urban-rural differences in long-term care service status and needs among home-based elderly people in China

2019 ◽  
Author(s):  
Liangwen Zhang ◽  
Yanbing Zeng ◽  
Ying Han ◽  
Lixia Wang ◽  
Ya Fang
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Long Term Care ◽  
The Elderly ◽  
Influential Factors ◽  
Term Care ◽  
Home Based ◽  
Urban Rural ◽  
Young Old

Abstract Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban-rural differences. This study aims to evaluate the differences of LTC current status and needs between urban-rural areas and to identify influencing factors causing the different LTC needs. Methods: The data comes from the Chinese Longitudinal Health Longevity Survey in 2014. 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (P＜0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health, and less autonomy had higher anticipated needs for LTC services (ORs>1, P＜0.01). Compared with the young-old in rural, the young-old in urban were prone to live alone (ORs=1.61, P＜0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1＜ORs＜1.69, P＜0.05).Conclusions: The aged cohort in urban-rural distinction were facing an increasing need of immediate care due to the inadequate supports being provided, especially among rural elderly. The oldest old in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support and health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.

Status and Degree of Dysphagia in the Elderly-A Comparison Study of Long-Term Care Elderly People in an Outpatient Clinic

2003 ◽  
Vol 54 (4) ◽  
pp. 277-284 ◽  
Author(s):  
Masanori Komatsu ◽  
Kayoko Hirata ◽  
Idumi Mochimatsu ◽  
Kazuo Matsui ◽  
Hajime Hirose ◽  
...  
Keyword(s):  
Elderly People ◽  
Outpatient Clinic ◽  
Long Term Care ◽  
The Elderly ◽  
Comparison Study ◽  
Term Care

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

scholarly journals Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 176-176
Author(s):  
Hiroto Yoshida ◽  
Yuriko Kihara
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Elderly Age ◽  
Term Care ◽  
Intentional Weight Loss ◽  
Long Term Care Insurance ◽  
And Gender ◽  
The Impact

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

A Model for Working with the Elderly in Institutions

1981 ◽  
Vol 62 (7) ◽  
pp. 420-425 ◽  
Author(s):  
Alicia S. Cook
Keyword(s):  
Theoretical Model ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Human Needs

Abraham Maslow's hierarchy of human needs provides a useful operating framework for professionals working with residents of long-term care institutions. The difficulties and obstacles that the elderly often encounter in these facilities are addressed and discussed for each level of the theoretical model.

A Study of Patterns of Dying in a Multilevel Geriatric Setting

1983 ◽  
Vol 2 (2) ◽  
pp. 79-85
Author(s):  
Isabel Brown
Keyword(s):  
Retrospective Study ◽  
Long Term Care ◽  
Death And Dying ◽  
Chronically Ill ◽  
The Elderly ◽  
Care Hospital ◽  
Term Care ◽  
Apartment Complex ◽  
General Community

ABSTRACTA retrospective study was conducted in a large multilevel geriatric centre to analyse the deaths reported in the year 1981. This centre provides accommodation for 750 elderly and/or chronically ill persons in three agencies—an apartment complex, a home for the aged, and a long-term care hospital The study revealed that the hospital is the place of death for a high proportion of the elderly residents of the centre. In particular, residents of the home for the aged are unlikely to remain in the “home” to die. It was found that patterns of death and dying for individuals admitted to the hospital from the general community differ in several ways from the patterns of those who are already living in the centre in terms of age and probable cause of death.

Factors Affecting the Long-Term Care Preferences of the Elderly in Taiwan

2008 ◽  
Vol 29 (5) ◽  
pp. 293-301 ◽  
Author(s):  
Min-Huey Chung ◽  
Nanly Hsu ◽  
Yin-Chun Wang ◽  
Herng-Ching Lin ◽  
Ya-Li Huang ◽  
...  
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Factors Affecting
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