scholarly journals Simulating the Impact of Long-Term Care Prevention Among Older Japanese People on Healthcare Costs From 2020 to 2040 Using System Dynamics Modeling

2020 ◽  
Vol 8 ◽  
Author(s):  
Nobuo Nishi ◽  
Nayu Ikeda ◽  
Takehiro Sugiyama ◽  
Kayo Kurotani ◽  
Motohiko Miyachi
Keyword(s):  
Healthcare Costs ◽  
Long Term Care ◽  
Dynamics Modeling ◽  
Japanese People ◽  
Care Needs ◽  
Term Care ◽  
Death Rates ◽  
Annual Reduction ◽  
The Impact

Objectives: This study examined how healthcare costs might change by reducing long-term care needs among older Japanese people.Methods: A simulation model was constructed comprising two aging chains for independent and dependent people aged ≥65 years by sex. Changes in the base run from 2020 to 2040 were compared with those in two hypothetical scenarios: a 2% annual reduction in death rates (S1), and S1 plus a 2% annual reduction in the proportion of dependent people aged 65 years and in transition rates from the independent to dependent state for people aged ≥65 years (S2).Results: In the base run, the population increased by 13.0% for men and 11.3% for women, and the proportion of dependent people increased by 4.6% for men but decreased by 13.4% for women. The sum of medical and long-term care expenditure increased in the base run, S1, and S2 by 8.2, 27.4, and 16.4%, respectively, for men and women combined.Conclusions: Healthcare costs will increase as death rates fall, but the increase will be attenuated if the proportion of dependent people decreases.

scholarly journals The impact of community paramedicine interventions on Transfers from Long Term Care to Emergency Departments: A systematic review

2021 ◽  
Author(s):  
Abraham Munene ◽  
Dominic Alaazi ◽  
Jane Mathew ◽  
Patrick McLane ◽  
Greta Cummings ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Departments ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Community Paramedicine ◽  
Review Articles ◽  
System P ◽  
The Impact

OBJECTIVES: Long term care (LTC) facilities are essential in the provision of daily care needs for older adults experiencing frailty. In times of acute medical distress, LTC residents may require transfer to emergency departments (ED). However, many transfers from the LTC to ED may not be required and residents could instead be treated within LTC utilizing community paramedics (CP). We conducted a systematic review to assess the impact of community paramedicine on the frequency of resident transfer from LTC to ED. METHODS: We searched five electronic databases (Medline, CINAHL, PubMed, Embase, and Cochrane). The search was limited to primary peer-reviewed publications and excluded conference proceedings, review articles, and non-peer review articles. We restricted the search to papers published in English and articles published within the last 30 years. RESULTS: A total of 19,308 titles and abstracts were screened with a total of 181 full text reviews. One study that comprised of 4 articles was included in the review that evaluated the impact of community paramedic interventions in LTC. The study noted a reduction in transfers to the ED attributed to the presence of CP, reducing transports to ED by nearly 30%. CONCLUSIONS: There is a scarcity of research examining the role of CP in LTC. While the current research points towards CP interventions in LTC reducing the number of transfers to ED, further research needs to be conducted on the effectiveness of community paramedicine interventions in improving health outcomes for residence and improving cost efficiency within the health system.

Modelling ageing populations to 2030: financing long-term care in England

2018 ◽  
Author(s):  
Michael Murphy ◽  
Ruth Hancock ◽  
Raphael Wittenberg ◽  
Bo Hu ◽  
Marcello Morciano ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Public And Private ◽  
Care Services ◽  
Private Expenditure ◽  
The Impact ◽  
Care Costs

This chapter presents some findings from the research project ‘Modelling Needs and Resources of Older People to 2030’ (MAP2030). The project developed a set of projection models to estimate future family circumstances, incomes, pensions, savings, disability and care needs of older people in England. These projections included public and private expenditure on pensions, disability benefits and care services under different scenarios for reform of pensions and long-term care funding under a range of alternative population futures. The chapter focuses on the projected future costs and impacts for the different income quintiles of the older population of proposed reforms to the system of funding adult social care, in particular the impact of a cap on individual liability to meet care costs.

scholarly journals Complex Multimorbidity and Incidence of Long-Term Care Needs in Japan: A Prospective Cohort Study

2021 ◽  
Vol 18 (19) ◽  
pp. 10523
Author(s):  
Daisuke Kato ◽  
Ichiro Kawachi ◽  
Junko Saito ◽  
Naoki Kondo
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Long Term Care ◽  
Japanese People ◽  
Insurance Scheme ◽  
Care Needs ◽  
Term Care ◽  
Inverse Probability

Complex multimorbidity (CMM) has been proposed as a more nuanced concept of multimorbidity (MM). We sought to quantify the association of CMM and MM on the incidence of long-term care (LTC) needs in a cohort of older Japanese people. Our follow-up was based on a nationwide longitudinal cohort study of people aged over 65 years who were functionally dependent at baseline. Our outcome was incident LTC needs, based on certification under the Japanese LTC insurance scheme. We used both propensity score matching and inverse probability of treatment weights (IPTW) to compare individuals with and without MM versus CMM. A total of 38,889 older adults were included: 20,233 (52.0%) and 7565 (19.5%) adults with MM and CMM, respectively. In propensity-matched analyses, both MM (n = 15,666 pairs) and CMM (n = 7524 pairs) were statistically significantly associated with the six-year LTC insurance certification rate (MM, hazard ratio (HR) 1.07, 95% confidence interval (95%CI) 1.02–1.12; CMM, HR 1.10, 95%CI 1.04–1.16). Both MM and CMM were associated with a modest but statistically significantly higher rate of LTC insurance certification. These findings support the inclusion of multimorbidity in the assessment of LTC insurance needs, although the Japanese government currently has not adopted this.

scholarly journals Dependent, Poorer, and More Care-Demanding? An Analysis of the Relationship between Being Dependent, Household Income, and Formal and Informal Care Use in Spain

2021 ◽  
Vol 18 (8) ◽  
pp. 4339
Author(s):  
Beatriz Rodríguez-Sánchez ◽  
Marta Pascual Sáez ◽  
David Cantarero-Prieto
Keyword(s):  
Social Services ◽  
Informal Care ◽  
Household Income ◽  
Long Term Care ◽  
Personal Autonomy ◽  
Care Needs ◽  
Demographic Ageing ◽  
Term Care ◽  
The Impact

Population ageing is one of the current challenges that most societies are facing, with great implications for health systems and social services, including long-term care. This increasing long-term care use is particularly rising for dependent older people, motivating the implementation of regional dependency laws to ensure their care needs’ coverage. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from the year 2004 until 2017, the aim of this study is to assess the impact that the Spanish System for Personal Autonomy and Dependency might have on (i) household income, according to different needs for care levels, by running Generalized Linear Models (GLMs); and (ii) formal and informal care use depending on the income-related determinant through the performance of logit random-effects regression models. We show that the different degrees of needs for personal care are associated with a lower household income, being associated with an income reduction from €3300 to nearly €3800, depending on the covariates included, per year for the more severely in-need-for-care older adults. Moreover, our findings point towards a higher use of formal and informal care services by the moderate and severe dependents groups, regardless of the household income group and time period. Bearing in mind the demographic ageing, our results highlight the need for the identification of potentially vulnerable populations and the efficient planification of long-term care systems and social support services.

scholarly journals Impact of Outpatient Rehabilitation Service in Preventing the Deterioration of the Care-Needs Level Among Japanese Older Adults Availing Long-Term Care Insurance: A Propensity Score Matched Retrospective Study

2019 ◽  
Vol 16 (7) ◽  
pp. 1292 ◽  
Author(s):  
Michio Maruta ◽  
Takayuki Tabira ◽  
Hyuma Makizako ◽  
Akira Sagari ◽  
Hironori Miyata ◽  
...  
Keyword(s):  
Older Adults ◽  
Retrospective Study ◽  
Propensity Score ◽  
Social Life ◽  
Long Term Care ◽  
Outpatient Rehabilitation ◽  
Care Needs ◽  
Term Care ◽  
The Impact

Outpatient rehabilitation (OR) and outpatient day long-term care (ODLC) services are frequently used by older adult patients in Japan. However, there is a need to clarify that OR service, which has more rehabilitation professionals than ODLC, has the role of providing rehabilitation. This retrospective study examined the impact of OR services by comparing the two services based on City A data from the care-needs certification survey conducted between 2015 to 2017. We performed a propensity score matched analysis to compare the changes in the care level and function of OR and ODLC users after two years. The results showed that OR users showed a lower deterioration in care levels and less decline in the activities of daily living (ADL) in dementia and adaptation to social life. In the analysis of older adults requiring support, OR users had a lower deterioration in care levels and less decline in the ADL in dementia and behavioral and psychological symptoms than ODLC users did. There was no difference between the two services with respect to older adults requiring long-term care. The OR service has had an increasingly preventive effect on the deterioration of care levels compared to the ODLC service, which was particularly evident in older adults requiring support.

scholarly journals Understanding Attitudes to Paying for Care amongst Equity Release Consumers: citizenship, solidarity and the ‘hardworking homeowner’

2016 ◽  
Vol 46 (1) ◽  
pp. 49-67 ◽  
Author(s):  
LOUISE OVERTON ◽  
LORNA FOX O'MAHONY
Keyword(s):  
Long Term Care ◽  
Central Element ◽  
Asset Accumulation ◽  
Care Needs ◽  
Term Care ◽  
Policy Makers ◽  
The Uk ◽  
The Impact ◽  
Housing Equity

AbstractThe importance of developing a system that is perceived to be ‘fair’ is a central element in debates about long-term care funding in the UK. It is therefore surprising that while previous research has established that older people tend to resent the idea of using housing equity, and other personal assets, it has often revealed little about the factors underpinning these attitudes or reflected on how they sit within a wider frame of social and political norms. Drawing on 60 semi-structured in-depth interviews with older home owners who have released equity from their homes, this paper exploreswhypeople feel that it is fair, or unfair, to require owners to use their housing equity to fund long-term care needs, once factors like reluctance to trade on the home, and mistrust of equity release products, have been excluded. While a small majority of our participants considered it unfair, a substantial minority thought it fair that they were required to use their accumulated housing equity to meet care needs. This distribution of attitudes enabled us to explore the reasons why participants held each view, and so reflect on the impact of pro-social and pro-individual norms in shaping attitudes towards intra-generational fairness and ideas about ‘responsible citizenship’. Our analysis posits that the factors that shape attitudes toward using housing assets to pay for care, and their relationship to the wider rhetorical framework of asset accumulation, management and decumulation, have been misunderstood by policy makers. We discuss the implications of our findings for policies that seek to promote the development of a housing-asset based care funding system capable of attracting widespread support.

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