scholarly journals Heaviness, intensity, and intimacy

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Josien de Klerk ◽  
Barbara Da Roit
Keyword(s):  
Health Care ◽  
Moral Obligation ◽  
Long Term Care ◽  
Social Embeddedness ◽  
The Political ◽  
Term Care ◽  
Policy Makers ◽  
Self Sufficiency ◽  
Community Solidarity

In the Netherlands the recent shift to a ‘participation society’ has led to a reconfiguration of health care arrangements for long-term care. The new long-term care act, scheduled to commence January 2015, forms the political realization of the participation society: people are expected to decrease their dependency on state provisions and instead become self-sufficient or dependent on family and community solidarity. In this Think Piece we argue that the implicit references of policy makers to pre-welfare state community solidarity and self-sufficiency do not adequately consider the historical and social embeddedness of care. Referring to Rose’s concept of ‘politics of conduct’ we argue that in framing care as a moral obligation, the current politics of conduct may obscure the physical and psychological heaviness of intimate care between family members, the diversity of care relations, and their sociohistorical embeddedness.

scholarly journals Long-term care coverage and its relationship with hospital care: Lessons from Italy on coordination among care-settings

2020 ◽  
Vol 33 (4) ◽  
pp. 186-199
Author(s):  
Elisabetta Notarnicola ◽  
Alessandro Furnari ◽  
Francesco Longo ◽  
Giovanni Fosti
Keyword(s):  
Health Care ◽  
Hospital Care ◽  
Long Term Care ◽  
Substitution Effect ◽  
Care Providers ◽  
Care Needs ◽  
Term Care ◽  
Policy Makers ◽  
Care System

Long-term care for the elderly is one among the most important challenges for welfare and health care system across the world. Demographic and epidemiological trends are signalling that demand for long-term care will continue increasing in the next future, while public systems investments and efforts to cope with this issue are not enough. One possible strategy could be to reinforce integration between different care settings so to have positive spill over effects. The paper is focussed on Italian long-term care system analysing and assessing its performance at the regional level both in terms of answering citizens’ long-term care needs and integrating with hospital care. The study is based on National health care records and regional data concerning long-term care to assess the state of the arts of in-kind services, and on qualitative focus groups with care providers and policy makers to provide interpretation about the Italian long-term care system performance and weaknesses. Results show that, due to a widespread and important lack of supply and inability to answer to citizens’ needs, integration between long-term care and hospitals is not working, and substitution effect following investment in long-term care settings is not present. The paper introduces different interpretations of the causes of this phenomenon, suggesting to policy makers and managers the possible solutions to be implemented.

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.

scholarly journals Person-Centered Health Care: An Approach That Integrates Acute and Long-Term Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 704-704
Author(s):  
Yuchi Young ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Systems ◽  
Long Term Care ◽  
The United States ◽  
World Population ◽  
Term Care ◽  
The Usa ◽  
Aged Society

Abstract The world population is aging. The proportion of the population over 60 will nearly double from 12% in 2015 to 22% in 2050. Global life expectancy has more than doubled from 31 years in 1900 to 72.6 years in 2019. The need for long-term care (LTC) services is expanding with the same rapidity. A comprehensive response is needed to address the needs of older adults. Learning from health systems in other countries enables health systems to incorporate best long-term care practices to fit each country and its culture. This symposium aims to compare long-term care policies and services in Taiwan, Singapore, and the USA where significant growth in aging populations is evidenced. In 2025, the aging population will be 20% in Taiwan, 20% in Singapore and 18 % in the USA. In the case of Taiwan, it has moved from aging society status to aged society, and to super-aged society in 27 years. Such accelerated rate of aging in Taiwan is unparalleled when compared to European countries and the United States. In response to this dramatic change, Taiwan has passed long-term care legislation that expands services to care for older adults, and developed person-centered health care that integrates acute and long-term care services. Some preliminary results related to access, care and patterns of utilization will be shared in the symposium. International Comparisons of Healthy Aging Interest Group Sponsored Symposium.

Aging, health expenditure, proximity to death, and income in Finland

2008 ◽  
Vol 3 (2) ◽  
pp. 165-195 ◽  
Author(s):  
UNTO HÄKKINEN ◽  
PEKKA MARTIKAINEN ◽  
ANJA NORO ◽  
ELINA NIHTILÄ ◽  
MIKKO PELTOLA
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
Long Term Care ◽  
Health Care Expenditure ◽  
Term Care ◽  
Age And Gender ◽  
And Gender ◽  
Proximity To Death ◽  
Naive Model

AbstractThis study revisits the debate on the ‘red herring’, i.e. the claim that population aging will not have a significant impact on health care expenditure (HCE), using a Finnish data set. We decompose HCE into several components and include both survivors and deceased individuals into the analyses. We also compare the predictions of health expenditure based on a model that takes into account the proximity to death with the predictions of a naïve model, which includes only age and gender and their interactions. We extend our analysis to include income as an explanatory variable. According to our results, total expenditure on health care and care of elderly people increases with age but the relationship is not as clear as is usually assumed when a naïve model is used in health expenditure projections. Among individuals not in long-term care, we found a clear positive relationship between expenditure and age only for health centre and psychiatric inpatient care. In somatic care and prescribed drugs, the expenditure clearly decreased with age among deceased individuals. Our results emphasize that even in the future, health care expenditure might be driven more by changes in the propensity to move into long-term care and medical technology than age and gender alone, as often claimed in public discussion. We do not find any strong positive associations between income and expenditure for most non-LTC categories of health care utilization. Income was positively related to expenditure on prescribed medicines, in which cost-sharing between the state and the individual is relatively high. Overall, our results indicate that the future expenditure is more likely to be determined by health policy actions than inevitable trends in the demographic composition of the population.

The Impacts of Long-Term Care Insurance on Health Care Utilization and Expenditure: Evidence From China

2022 ◽  
Author(s):  
He Chen ◽  
Jing Ning
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Treatment Effect ◽  
Health Expenditure ◽  
Long Term Care ◽  
Care Utilization ◽  
Ageing Population ◽  
Term Care ◽  
Long Term Care Insurance

Abstract Long-term care insurance (LTCI) is one of the important institutional responses to the growing care needs of the ageing population. Although previous studies have evaluated the impacts of LTCI on health care utilization and expenditure in developed countries, whether such impacts exist in developing countries is unknown. The Chinese government has initiated policy experimentation on LTCI to cope with the growing and unmet need for aged care. Employing a quasi-experiment design, this study aims to examine the policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure in China. The Propensity Score Matching with Difference-in-difference approach was used to analyse the data obtained from four waves of China Health and Retirement Longitudinal Study (CHARLS). Our findings indicated that, in the aspect of health care utilization, the introduction of LTCI significantly reduced the number of outpatient visits by 0.322 times (p<0.05), the number of hospitalizations by 0.158 times (p<0.01), and the length of inpatient stay during last year by 1.441 days (p<0.01). In the aspect of out-of-pocket health expenditure, we found that LTCI significantly reduced the inpatient out-of-pocket health expenditure during last year by 533.47 yuan (p<0.01), but it did not exhibit an impact on the outpatient out-of-pocket health expenditure during last year. LTCI also had a significantly negative impact on the total out-of-pocket health expenditure by 512.56 yuan. These results are stable in the robustness tests. Considering the evident policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure, the expansion of LTCI could help reduce the needs for health care services and contain the increases in out-of-pocket health care expenditure in China.

Dentistry and nursing working together to improve oral health care in a long-term care facility

2019 ◽  
Vol 40 (2) ◽  
pp. 197-204 ◽  
Author(s):  
Mark Keboa ◽  
Anne Beaudin ◽  
Julie Cyr ◽  
Janick Decoste ◽  
Frances Power ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Long Term Care ◽  
Care Facility ◽  
Oral Health Care ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Working Together

scholarly journals Long-term Care Financing: Inserting Politics and Resource Allocation in the Debate Comment on "Financing Long-term Care: Lessons From Japan"

2019 ◽  
Vol 9 (2) ◽  
pp. 77-79 ◽  
Author(s):  
Cristiano Gori
Keyword(s):  
Resource Allocation ◽  
Long Term Care ◽  
Economic Resources ◽  
The Other ◽  
The Political ◽  
Care Needs ◽  
Term Care ◽  
International Debate ◽  
Financing Policies

The ageing of the countries’ populations, and in particular the growing number of the very old, is increasing the need for long-term care (LTC). Not surprisingly, therefore, the financing of LTC systems has become a crucial topic across the Organisation for Economic Co-operation and Development (OECD). In the last three decades, various financing policies have been carried out in different countries and the related international debate has grown. The latter has so far focused mostly on the different alternatives to collect economic resources to pay for care. The international debate needs now to focus also on other issues, so far less discussed. One is the politics of LTC: the degree and nature of the political interest in LTC, that affects the size and profile of public financing. The other is resource allocation: how different services and benefits are distributed among people with different care needs, that determines if resources made available are optimized. If we do not pay more attention to these issues – inextricably connected to policies aimed to collect funds – our understanding of LTC financing will remain inevitably limited.

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