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.

scholarly journals Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China

2020 ◽  
Vol 17 (5) ◽  
pp. 1701
Author(s):  
Liangwen Zhang ◽  
Yanbing Zeng ◽  
Lixia Wang ◽  
Ya Fang
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Influential Factors ◽  
Term Care ◽  
Home Based ◽  
Urban Rural ◽  
Young Old

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 age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 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 having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 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 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, 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.

Long-Term Care for Older Adults in ASEAN Plus Three: The Roles of Family, Community, and the State in Addressing Unmet Eldercare Needs

2018 ◽  
Vol 30 (10) ◽  
pp. 1499-1515 ◽  
Author(s):  
Wei-Jun Jean Yeung ◽  
Leng Leng Thang
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Long Term Care ◽  
Elderly Women ◽  
Unmet Need ◽  
Care Plan ◽  
Cultural Norms ◽  
Term Care ◽  
Home Based

Objective: To introduce this Special Issue that focuses on understanding the issues surrounding the long-term care (LTC) in selected societies in Southeast and East Asian countries. Method: We first provide demographic and socioeconomic context for these countries and then summarize the seven articles in this issue. Results: The articles highlight the rapidly rising demand for LTC in this region in the next few decades given the declining fertility, lengthening life expectancy, and increasing migration. They also discuss challenges and strategies in meeting these demands. Most countries are ill prepared to cope with the demand for LTC with older adults heavily rely upon female family members for care. Elderly women in low-income households have the greatest unmet need. Discussion: Home-based and community-based services are set to become an integral part of the LTC system. It is important to incorporate older adults’ cultural norms and wishes in their care plan and provision.

scholarly journals Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Pattaraporn Khongboon ◽  
Sathirakorn Pongpanich
Keyword(s):  
Informal Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Socioeconomic Development ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Rural And Urban Areas ◽  
Rural And Urban

Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

scholarly journals Telemedicine and Geriatrics in France: Inventory of Experiments

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
A. A. Zulfiqar ◽  
A. Hajjam ◽  
S. Talha ◽  
M. Hajjam ◽  
J. Hajjam ◽  
...  
Keyword(s):  
Long Term Care ◽  
The Elderly ◽  
Population Ageing ◽  
Care Homes ◽  
Communication Tools ◽  
Term Care ◽  
Sharp Focus ◽  
Home Based ◽  
Institutionalized Patients

Telemedicine is now in vogue, being deployed through computer and communication tools in various health fields, such as diabetology, nephrology, dermatology, neurology, and cardiology. With population ageing, geriatrics is coming into sharp focus. Telemedicine practices differ for home-based or institutionalized patients in long-term care homes. We take a look at telemedicine projects in France concerning the elderly.

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 Analysis of the Influencing Factors on the Preferences of the Elderly for the Combination of Medical Care and Pension in Long-Term Care Facilities Based on the Andersen Model

2020 ◽  
Vol 17 (15) ◽  
pp. 5436
Author(s):  
Yong Wei ◽  
Liangwen Zhang
Keyword(s):  
Medical Care ◽  
Rural Areas ◽  
Long Term Care ◽  
Economic Status ◽  
The Elderly ◽  
Education Level ◽  
Enabling Factors ◽  
Term Care ◽  
Andersen Model

Background: The purpose of this study is to evaluate the status quo and factors that influence the preferences of the elderly for the combination of medical care and pension (CMCP) in long-term care (LTC) facilities and to provide an evidence-based basis for building a multi-tiered, continuous LTC system with CMCP. Methods: Using a multi-stage sampling method, face-to-face questionnaire surveys were conducted on 3260 elderly people aged 60 years or over in 44 communities in 16 sub-districts in six districts in Xiamen. Based on the Andersen model, the chi-square test was used to analyze differences in population distribution, and binary logistic regression analysis was used to analyze the factors affecting the elderly’s preference for CMCP in LTC institutions in terms of the factors of predisposition, enablement, and personal needs. Results: Most elderly people choose traditional home care (82.01%), and only 12.89% choose LTC facilities with CMCP. This choice is influenced by a number of predisposing factors. The elderly who are at the upper end of the age range, have a higher education level, and live in rural areas are more likely to choose CMCP (odds ratio (OR) value greater than 1, p < 0.05). With regard to enabling factors, the elderly who were married, mainly taken care of by spouses, and had better economic status also tended to choose CMCP (OR > 1, p < 0.01). In terms of personal needs, the elderly with worse self-care status tended to choose CMCP (OR > 1, p < 0.01). Enabling factors have the largest contribution to the model, and they have the greatest impact on elder preference for CMCP services. In addition, the elderly with higher age and education level, non-remarried, with better economic status, and with poorer health status have a demand for a wider variety of CMCP services. Compared to those in urban areas, the elderly in rural areas have greater needs, mainly related to personal care, medical care, and psychological counseling. Conclusion: The preference of the elderly for CMCP are lower compared to their preference for home care in Xiamen, China. Preference for CMCP is affected by a range of factors such as age, education level, residence, income, and self-care ability, among which the enabling factors have the greatest impact.

scholarly journals DISPARITIES IN ACCESSING DIFFERENT TYPES OF LONG-TERM CARE SERVICES IN TAIWAN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S157-S158
Author(s):  
Ya-Mei Chen ◽  
Shih-Chi Lin ◽  
Hsiao-Wei Yu ◽  
Shwu-Chong Wu ◽  
Shih-Cyuan Wu ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Long Term Care ◽  
Sociodemographic Factors ◽  
Care Plan ◽  
Claim Database ◽  
Term Care ◽  
Income Status ◽  
Home Based

Abstract A growing body of evidence documents pervasive social and demographic factors relating to disparities in long-term care (LTC). In 2007, Taiwan implemented its Ten-year Long-Term Care Plan version 1.0 (TLTCP 1.0) that aimed to develop a home-and community-based (HCBS) LTC system. In 2016, Taiwan began to implement TLTCP 2.0. To continue providing effective LTC, this study aimed to assess the disparities in access to LTC services using Taiwan’s LTC claim database from 2010 to 2013. A total of 87,438 older adults who had applied for LTC services from the TLTCP 1.0 were included. The study assessed LTC disparities related to five sociodemographic factors, including age, gender, living status, urbanization, and income status. Sixteen types of LTC services, including HCBS, home-based professional care, meal services, transportation, and institutional services were assessed. After controlling for the level of disability, we found that those who were older-old (age 80&gt; over), male, and low-income were less likely to use HCBS, but more likely to use institutions services (p &lt; 0.001). We also found that those who lived in the city were more likely to use HCBS and transportation services (p &lt; 0.001). Yet, older adults living alone were more likely to use home care and meal services but not other types of LTC services (p &lt; 0.001). In conclusion, the social disparities in access to LTC services in Taiwan remains, suggesting LTC 2.0 should continue monitoring and placing the LTC equity issue on the top priority.

scholarly journals Dimensions assigned to Long Term Care Facilities by managers and health professionals: interfaces and contradictions

2018 ◽  
Vol 21 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Bárbara Jacome Barcelos ◽  
Natália de Cássia Horta ◽  
Quesia Nayrane Ferreira ◽  
Marina Celly Martins Ribeiro de Souza ◽  
Cristiane Delesporte Pereira Mattioli ◽  
...  
Keyword(s):  
Health Professionals ◽  
Long Term Care ◽  
The Elderly ◽  
Daily Basis ◽  
Term Care ◽  
Daily Lives ◽  
Home Based ◽  
Care Facilities ◽  
Belo Horizonte

Abstract Objective: to analyze the dimensions assigned to long term care facilities for the elderly (LTCFs) by managers and health professionals. Method: a descriptive-exploratory study with a qualitative approach was conducted in the metropolitan area of Belo Horizonte, through ten focus groups with 51 managers and health professionals. Analysis was based on the content of the interviews. Results: considering the most common themes, three empirical categories emerged that explained the consensuses and contradictions present in the empirical material: a) the LTCF and the perpetuation of the asylum space; b) the LTCF as a space for health treatment c) a home: convergences and contradictions in the LTCF. Initially, findings relating to the political definition of the LTCF directly linked to social organs are evidenced. In the second category, LTCFs are described negatively, perpetuating the stigma of the term "asylum" which still reverberates in their daily lives. As a treatment space, LTCFs are considered health facilities due to the services offered and the presence of health professionals on a daily basis. In the third analysis, they are recognized as a home, based on current legislation that describes the LTCF as a collective, residential area. Conclusion: it is important to discuss the different attributes given to the LTCF to create resolutive actions in the care of the institutionalized elderly. The importance of thinking about the rights to health of the elderly and the need to understand how they inhabit this space is also emphasized.

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