scholarly journals Profile of Long-Term Care Recipients Receiving Home and Community-Based Services and the Factors That Influence Utilization in Taiwan

2020 ◽  
Vol 17 (8) ◽  
pp. 2649
Author(s):  
Chia-Mei Shih ◽  
Yu-Hua Wang ◽  
Li-Fan Liu ◽  
Jung-Hua Wu
Keyword(s):  
Low Income ◽  
Long Term Care ◽  
Common Factor ◽  
Behavioral Model ◽  
Care Needs ◽  
Community Based ◽  
Term Care ◽  
Care Recipients ◽  
Community Based Services

In response to the irreversible aging trend, the Taiwan government has promoted the Long-Term Care (LTC) policy 1.0 launched in 2007 and the LTC policy 2.0 reform since 2016. This study aimed to explore the utilization of formal home and community-based care under LTC policy 1.0 to add scientific support for the on-going LTC policy 2.0 reform. Methods: By using Andersen and Aday’s behavioral model of healthcare utilization, the long-term care dataset was analyzed from 2013 to 2016. A total of 101,457 care recipients were identified after data cleaning. Results: The results revealed that about 40.7% of the care recipients stayed in the care system for more than two years. A common factor influencing the length of home and community-based services (HCBS) utilization period included need factors, where more dependent recipients leave the LTC system regardless of their socio-economic status. However, the utilization period of non-low-income households is significantly affected by the level of service resources. Conclusion: For long-term care needs, the phenomenon of a short utilization period was concerning. This study adds information which suggests policy should reconsider care capacity and quality, especially for moderate to severely dependent recipients. This will allow for better understanding to help maintain care recipients in their own communities to achieve the goal of having an aging in place policy.

scholarly journals EFFECTIVENESS OF HOME- AND COMMUNITY-BASED SERVICES IN DECREASING HEALTH CARE EXPENDITURE IN TAIWAN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S159-S159
Author(s):  
Ya-Mei Chen ◽  
Hsiao-Wei Yu ◽  
Ying-Chieh Wang
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Long Term Care ◽  
Community Based ◽  
Term Care ◽  
Care Recipients ◽  
Home Based ◽  
Number Of Visits ◽  
Community Based Services

Abstract Ideally, continuum of care involves wide-ranging health and long-term care (LTC) services. Taiwan’s National Health Insurance scheme and 10-Year Long-term Care Plan attempts to provide universal and fundamental services of continuum care. However, the accessibility of these services for care recipients remains unclear. This study aims to examine the effectiveness of continuum care in decreasing the healthcare expenditure of LTC recipients using home- and community-based services (HCBS). Data collated from the 2010–2013 Long-Term Care Service Management System (N = 77,251) were subjected to latent class analysis to identify subgroups of recipients using HCBS. Subsequently, the 1-year primary care expenditure after receiving HCBS was compared through generalized linear modeling. Three discrete HCBS subgroups were found: home-based personal care (HP), home-based health care (HH), and community-based care (CC). No difference in the number of visits to doctors and the average primary care expenses was observed between the HP and HH subgroups. However, considering physical and psychosocial confounders, care recipients in the CC subgroup recorded a higher number of visits to doctors (β = 3.05, SD = 0.25, p < 0.05) and lower primary care expenditure (β = -98.15, SD = 43.17, p = 0.02) than the other two subgroups. These findings suggest that LTC recipients in Taiwan may obtain better continuum care only for CC service recipients. Additionally, community-based LTC services may lower the cost of health expenditure after 1 year.

Use of Home- and Community-Based Services in Taiwan’s National 10-Year Long-Term Care Plan

2018 ◽  
Vol 39 (7) ◽  
pp. 722-730 ◽  
Author(s):  
Hsiao-Wei Yu ◽  
Yu-Kang Tu ◽  
Po-Hsiu Kuo ◽  
Ya-Mei Chen
Keyword(s):  
Daily Living ◽  
Long Term Care ◽  
Care Group ◽  
Community Based ◽  
Term Care ◽  
Use Patterns ◽  
Care Recipients ◽  
Home Based ◽  
Community Based Services

We aimed to understand the relationships between care recipients’ profiles and home- and community-based services (HCBS use patterns. Data were from the 2010 to 2013 Long-Term Care Service Management System in Taiwan ( N = 78,205). We used latent class analysis and multinomial logistic regression analyses. Three HCBS use patterns were found. Care recipients who lived alone, lived in less urbanized areas, and had instrumental activities of daily living disabilities were more likely to be in the home-based personal care group. Those in the home-based personal and medical care group were more likely than others to have a primary caregiver. Care recipients who had poorer abilities at basic activities of daily living and cognitive function, better household income, and lived in a more urbanized area were more likely to be in the non-personal care multiple services group. The findings suggest that policymakers alleviate barriers to accessing various patterns of HCBS should be encouraged.

scholarly journals Home- and Community-Based Services Use Patterns and Functional Improvement among Older Care Recipients in Taiwan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 906-907
Author(s):  
Hsiao-Wei Yu ◽  
Shih-Cyuan Wu ◽  
Ya-Mei Chen
Keyword(s):  
Long Term Care ◽  
Functional Improvement ◽  
Community Based ◽  
Term Care ◽  
Use Patterns ◽  
Care Services ◽  
Care Recipients ◽  
Home Based ◽  
Community Based Services

Abstract The new version of Taiwan’s 10-Year Long-Term Care Plan launched in 2016 aims to reinforce the integration of home- and community-based services (HCBS). The underlying HCBS use patterns and effectiveness of functional improvement among care recipients merit investigation. The purpose of the study was to examine the association of HCBS and changes in ADLs among care recipients with different levels of disabilities in Taiwan. We accessed the sub data of Taiwan’s Long-Term Care Services Management Online System. Samples were aged 65 and over and had completed records of baseline and reassessment information during 2018 (N = 4787). Latent class analysis and multivariate linear regression were applied to examine the relationship of HCBS and functional changes. Four HCBS subpatterns were found: home-based personal care services (home-based PS) (59.16%), home-based reablement services (home-based RS) (23.90%), home-based multiple services (home-based MS) (11.93 %), and community-based services (5.01%). In the cases with mild disabilities at baseline, recipients receiving home-based RS had higher probabilities of improving in ADLs among four HCBS subgroups (for example: β = 2.65, SE = 1.19 in comparison to home-based PS). Care recipients with moderate-to-severe disability at baseline, ADLs improvement was only found in home-based PS (β = 1.63, SE = 0.82 in comparison of home-based MS). In the cases with profound disabilities, home-based PS showed positive effects on ADLs improvement (β = 2.45, SE = 0.80 in ADLs, compared to home-based RS). The study suggested that HCBS subpatterns had different impacts on older adults with different disability levels.

scholarly journals Association Between Advanced Care Management and Progression of Care Needs Level in Long-Term Care Recipients: Retrospective Cohort Study

JMIR Aging ◽  
10.2196/11117 ◽  
2018 ◽  
Vol 1 (2) ◽  
pp. e11117 ◽  
Author(s):  
Sakiko Itoh ◽  
Hiroyuki Hikichi ◽  
Hiroshi Murayama ◽  
Miho Ishimaru ◽  
Yasuko Ogata ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Management ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Care Recipients

The Use of Community-Based Services in Long-term Care by Older Minority Persons

1979 ◽  
Vol 19 (4) ◽  
pp. 389-397 ◽  
Author(s):  
D. Holmes ◽  
M. Holmes ◽  
L. Steinbach ◽  
T. Hausner ◽  
B. Rocheleau
Keyword(s):  
Long Term Care ◽  
Community Based ◽  
Term Care ◽  
Community Based Services

Unmet Long-Term Care Needs: An Analysis of Medicare-Medicaid Dual Eligibles

2005 ◽  
Vol 42 (2) ◽  
pp. 171-182 ◽  
Author(s):  
Harriet L. Komisar ◽  
Judith Feder ◽  
Judith D. Kasper
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Long Term Care ◽  
Unmet Needs ◽  
State Governments ◽  
Care Needs ◽  
Community Based ◽  
Term Care ◽  
Dual Eligibles

People who are dually eligible for Medicare and Medicaid are the focus of fiscal struggles between federal and state governments. Drawing on a survey of community-based elderly “dual eligibles,” this paper examines how well their medical and long-term care needs are being met under the current combination of Medicare and Medicaid policies. While few people report difficulty getting medical care, 58% of people needing long-term care (help with activities of daily living) report unmet needs. As a result, many experience serious consequences, such as falls. Although unmet needs are substantial in all six states surveyed, we find the greater the use of paid home care in a state, the lower the likelihood of unmet needs, suggesting states' policies can make a difference.

Long-Term Care Goes to Market: Managed Competition and Ontario's Reform of Community-Based Services

1999 ◽  
Vol 18 (2) ◽  
pp. 125-153 ◽  
Author(s):  
A. Paul Williams ◽  
Jan Barnsley ◽  
Sandra Leggat ◽  
Raisa Deber ◽  
Pat Baranek
Keyword(s):  
Nous Avons ◽  
Long Term Care ◽  
Managed Competition ◽  
Community Based ◽  
Term Care ◽  
Longue Duree ◽  
Longue Durée ◽  
Community Based Services

RÉSUMÉLa désinstitutionnalisation et le virage vers les ressources communautaires posent des défis importants aux décideurs et aux dispensateurs de services, le plus important étant sans nul doute le défi de fournir un volume de services communautaires de haute qualité suffisant à répondre aux besoins de la clientèle. Ce défi est particulièrement évident dans les soins de longue durée (SLD), en raison de la complexité et de la diversité de ce champs d'action, de la vulnérabilité de la clientèle et de l'accroissement de la demande consécutive aux compressions dans le système hospitalier. Dans ce contexte, la dernière réforme des soins de longue durée en Ontario est particulièrement intéressante parce que, comme l'exprime le mot d'ordre gouvernemental «meilleure qualité au meilleur prix,» elle promet la coüt-efficacité tout en assurant le maintien ou l'amélioration de la qualité. Pour y arriver, on a recours à un modèle de «gestion de la concurrence» dans lequel les fournisseurs sans but lucratif et à but lucratif entrent en concurrence pour des contrats de services attribués par des Centres d'accès aux soins communautaires locaux, gérés par un conseil de bénévoles. Dans cette communication, nous avons utilisé les commentaires de hauts fonctionnaires et de représentants de fournisseurs de soins, ainsi que des documents du domaine public, pour mettre en lumière les questions et les problèmes soulevés par cette plus récente réforme provinciale. Nous soumettons que le modèle de gestion de la concurrence pourra entraîner la subordination de la qualité des services et du choix du consommateur aux impératifs de limitation des coûts, particulièrement dans le contexte actuel de budgets fermés et d'augmentation de la demande.

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