scholarly journals Aiming Higher: Advancing Public Social Insurance for Longterm Care to Meet the Global Aging Challenge Comment on "Financing Long-term Care: Lessons From Japan"

2019 ◽  
Author(s):  
Zhanlian Feng ◽  
Elena Glinskaya
Keyword(s):  
Social Insurance ◽  
Long Term Care ◽  
Model Building ◽  
Lessons Learned ◽  
Successful Implementation ◽  
Term Care ◽  
Middle Income ◽  
Policy Makers ◽  
Insurance Model

Globally, aging populations are driving the demand for long-term care (LTC) services for a growing number of older people with disabilities or chronic illnesses. A key challenge for policy-makers in all countries is to find a comprehensive solution to financing LTC services to make them widely accessible, affordable, and equitable for all in need. In this commentary, we make a case for LTC policy-makers and reformers across countries to take a long-term vision toward establishing a public, mandatory social insurance model of LTC financing. We first take a hard look at the LTC financing problems and the limitations of existing financing options. We then argue for a public social insurance approach to LTC financing and offer insights into several top-level insurance design features that are key to successful implementation of a public social insurance model, building on the experiences and lessons learned from Japan and other countries that have already "gotten there." We conclude with additional thoughts on the future of public LTC insurance in a global context, including the prospect of spreading this model to middle-income countries.

scholarly journals Leveraging Promising Policies to Support Long-Term Care Residents' Quality of Life Post-Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 369-370
Author(s):  
Deanne Taylor ◽  
Janice Keefe ◽  
Heather Cook
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Lessons Learned ◽  
Term Care ◽  
Policy Language ◽  
Policy Makers ◽  
Pandemic Planning ◽  
Health Decision

Abstract Long-term care (LTC) is highly regulated and often the policy language is complex and in tension with residents’ quality of life goals. Prior to COVID-19, LTC policy levers prioritized safety over other quality domains such as privacy, dignity, spirituality, and comfort. During the pandemic, this focus on safety regulations, while important, intensified in ways that often negatively impacted residents’ overall quality of life. In this symposium, we share findings from a five- year research project where we conducted a unique and expansive review of regulatory policy across four Canadian jurisdictions. We highlight how 11 different quality of life domains are supported and which texts offering promising policy language to enhance a well-rounded quality of life for residents. These are timely insights to offer as policy-makers look to the future and consider the lessons learned from the pandemic. We contend that creating more LTC policy is not a timely pathway forward to LTC reform. Instead, we suggest that existing policy can be leveraged when applied within a resident-centred quality of life lens. We will guide attendees through examples of existing promising policies highlighting how they might leveraged in planning for a better LTC system. The discussion will be rooted in our unique resident-centred approach to policy analysis using specific domains of quality of life and then applied to four different perspectives: residents, families, staff and volunteers. Our discussant a Ministry of Health decision-maker will address the implications of our research for post-pandemic planning to improve resident quality of life

scholarly journals ASSESSING THE EFFECTS OF LONG-TERM CARE INSURANCE ON EQUITY AND EFFICIENCY: A CASE STUDY OF QINGDAO CITY IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S300-S300
Author(s):  
Wei Yang ◽  
Shuang Chang
Keyword(s):  
Long Term Care ◽  
Financial Burden ◽  
Care Providers ◽  
Term Care ◽  
Middle Income ◽  
Middle Income Countries ◽  
Equity And Efficiency ◽  
Qingdao City ◽  
Insurance Model

Abstract The demand for equitable and efficient long-term care (LTC) has risen rapidly, and finding a suitable mechanism to finance LTC has become a pressing policy concern for many countries. A number of high income countries have chosen to use a social LTC insurance to fund the LTC system, but empirical assessments on such an insurance in low-and middle-income countries are limited. Using China as an example, this paper empirically assesses the performance of newly-piloted LTCNI by evaluating its impact on equity and efficiency in financing. We draw data from 47 in-depth interviews conducted with local government, care providers and family members of the LTCNI participants in Qingdao in 2016. We found that there remain sizable disparities in financial burden among LTCNI participants, despite of its emphasis on ensuring access to care based on people’s needs; care providers are incentivised to provide care at the least cost even this care is deemed as insufficient or inadequate due to fixed payment for their services. Our paper offers critical insights into the potential and challenges in applying LTC insurance model to a LMIC, where critical lessons can be drawn for public LTC insurance in other LMICs.

Barriers to linking research and policy: the case of long-term care in low and middle income countries

2015 ◽  
Vol 12 (2) ◽  
pp. 62-67 ◽  
Author(s):  
Peter Lloyd-Sherlock
Keyword(s):  
Long Term Care ◽  
Problem Definition ◽  
Negative Consequences ◽  
Term Care ◽  
Middle Income ◽  
Policy Makers ◽  
Middle Income Countries ◽  
Research And Policy ◽  
Low And Middle Income

Abstract This paper sets out a number of issues related to the translation of research into evidence and policy for long-term care (LTC) in low and middle income countries (LMICs). First, it assesses the role research can play in problem definition, including establishing the scale of long-term care demand in LMICs and identifying potential negative consequences of policy inaction. Second, it assesses the role that research can play in identifying and evaluating solutions to the problem, in the form of suitable policies and interventions. Lastly, it assesses mutual accessibility between researchers and policy-makers, paying particular attention to institutional and organisational structures. Applying this framework, the paper demonstrates that the capacity for research to influence long-term care policy is very limited. The paper calls for the establishment of an adequately resourced global institutional hub to support research in this area and to promote knowledge-sharing between academics and policy-makers.

Federalism and the Politics of Old-Age Care in Germany and the United States

2005 ◽  
Vol 38 (8) ◽  
pp. 887-914 ◽  
Author(s):  
Andrea Louise Campbell ◽  
Kimberly J. Morgan
Keyword(s):  
United States ◽  
Social Insurance ◽  
Long Term Care ◽  
The United States ◽  
Party Politics ◽  
Term Care ◽  
Policy Makers ◽  
Group Mobilization ◽  
The Welfare State

Until the early 1990s, Germany and the United States had similar systems of long-term care. At that time, Germany created a new social insurance program, whereas American reform efforts stalled. As conventional explanations of social policies—rooted in objective conditions, policy legacies, interest group mobilization, and party politics—fail to explain the diverging trajectories, the authors show how differing federal structures shaped reform efforts. German federalism gives states a strong voice and encourages collective responses to fiscal problems, enabling comprehensive restructuring of long-term care financing. In the United States, states lack a political mechanism to compel federal policy makers to tackle this subject. This analysis suggests reform of social welfare issues with weakly mobilized publics is unlikely without proxy actors that have institutional or political means to forcibly gain the attention of policy makers. In addition, scholars should pay more attention to “varieties of federalism” in analyses of the welfare state.

scholarly journals Projecting the Need for and Cost of Long-Term Care for Older Persons

2021 ◽  
Author(s):  
Wendy Holmes
Keyword(s):  
Older Persons ◽  
Long Term Care ◽  
Term Care ◽  
Middle Income ◽  
Policy Makers ◽  
Working Paper ◽  
Middle Income Countries ◽  
Modeling Studies ◽  
Key Issues

With the numbers of older persons in the Asia and Pacific region increasing rapidly, there is a growing urgency to develop and strengthen long-term care (LTC) support systems and services. This working paper aims to enhance the understanding, particularly of policy makers and those planning modeling studies, of using statistical models to project the need, demand, and cost of LTC services. The paper first outlines modeling and its importance. Second, it describes key concepts related to LTC need, demand, and measurement. Then, it identifies key issues to consider when designing and using models. A review of recent modeling studies is also summarized, drawing out lessons relevant to low- and middle- income countries.

scholarly journals Germany’s Long‐Term‐Care Insurance: Putting a Social Insurance Model into Practice

2000 ◽  
Vol 78 (3) ◽  
pp. 375-401 ◽  
Author(s):  
Max Geraedts ◽  
Geoffrey V. Heller ◽  
Charlene A. Harrington
Keyword(s):  
Social Insurance ◽  
Long Term Care ◽  
Term Care ◽  
Long Term Care Insurance ◽  
Insurance Model

OP48 Nursing Requirements In Long-Term Care: A Health Technology Assessment

2019 ◽  
Vol 35 (S1) ◽  
pp. 11-12
Author(s):  
Paula Corabian ◽  
Charles Yan ◽  
Susan Armijo-Olivo ◽  
Bing Guo
Keyword(s):  
Nursing Care ◽  
Nursing Staff ◽  
Real World ◽  
Research Evidence ◽  
Long Term Care ◽  
Staff Time ◽  
Term Care ◽  
Policy Makers ◽  
The Relationship

IntroductionThe objectives of this study were to systematically review published research on the relationship between nursing staff coverage, care hours, and quality of care (QoC) in long-term care (LTC) facilities; and to conduct a real world evidence (RWE) analysis using Alberta real world data (RWD) to inform policy makers on whether any amendments could be made to current regulations.MethodsA systematic review (SR) of research evidence published between January 2000 and May 2018 on the relationship between nursing staff coverage, care hours, and QoC in LTC facilities was conducted. Panel data regressions using available RWD from Alberta, Canada, were performed to assess associations between nursing care hours and LTC outcomes. Outcomes of interest included quality indicators related to resident outcomes, hospital admissions, emergency room visits and family satisfaction. Nursing care hours considered in SR and RWE analysis included those provided by registered nurses (RNs) and licensed practical nurses (LPNs).ResultsThe SR found inconsistent and poor quality evidence relevant to the questions of interest, indicating a great uncertainty about the association between nursing staff time and type of coverage and QoC. Although some positive indications were suggested, major weaknesses of reviewed studies limited interpretation of SR results. RWE analysis found that impact of care hours on LTC outcomes was heterogeneous, dependent on outcome measurements. There was evidence that total staff, RN, and LPN hours had positive effects on some resident outcomes and magnitude of effect differed for different nursing staff.ConclusionsNo definitive conclusion could be drawn on whether changing nursing staff time or nursing staff coverage models would affect residents’ outcomes based on the research evidence gathered in the SR. RWE analysis helped to fill a gap in the available published literature and allowed policy makers to better understand the impact of revising current regulations based on actual outcomes.

Evaluating and Motivating Activation in Long Term Care: Lessons From a Pilot Study

2021 ◽  
Vol 10 (1) ◽  
pp. 42-46
Author(s):  
J. Jbilou ◽  
A. El Bouazaoui ◽  
B. Zhang ◽  
J.L. Henry ◽  
L McDonald ◽  
...  
Keyword(s):  
Long Term Care ◽  
Driving Simulator ◽  
Care Home ◽  
Lessons Learned ◽  
Term Care ◽  
Care Facilities ◽  
Technological Intervention ◽  
The Impact ◽  
Research Recommendations

Older adults living in long-term care facilities typically receive insufficient exercise and have long periods of the day when they are not doing anything other than sitting or lying down, watching television, or ruminating (Wilkinson et al., 2017). We developed an intervention called the Experiential Centivizer, which provides residents with opportunities to use a driving simulator, watch world travel videos, and engage in exercise. We assessed the impact of the intervention on residents of a long-term care home in Fredericton, NB, Canada. In this paper, we report on the results observed and highlight the lessons learned from implementing a technological intervention within a long-term care setting. Practical and research recommendations are also discussed to facilitate future intervention implementation in long-term care.

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