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 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.

Quelques dilemmes, quelques valeurs pour une politique de services de longue durée

1995 ◽  
Vol 14 (2) ◽  
pp. 263-293 ◽  
Author(s):  
François Béland ◽  
Anne Lemay
Keyword(s):  
Medical Care ◽  
Long Term Care ◽  
Chronically Ill ◽  
The Elderly ◽  
Community Services ◽  
Provincial Government ◽  
Main Function ◽  
Term Care ◽  
Care Services

ABSTRACTLong-term care is available for individuals with functional incapacities. Long-term care includes medical, social, and personal hygiene services, which help to maintain the autonomy of the elderly and allows them to live with dignity in spite of loss of autonomy. This definition provides long-term care services with a goal and a clientele. However, are individuals with functional incapacities first and foremost chronically ill? Should long-term care services be conceptualized as independent from medical care? Provincial government policy documents promote a social model of long-term care which privileges community services as opposed to institutional services. What in fact does this choice imply? To what extent have resources been allocated in accordance with these objectives? A study of these questions based on Canadian data on the relationship between illnesses, disabilities and functional incapacity and data from a historical survey of expenditures in Quebec for hospital care, medical care, institutional long-term care and community services indicates that illnesses, disabilities, and functional incapacity, although strongly correlated in an elderly population, cannot be collapsed into one big category for planning services; co-ordinated services in a multidisciplinary approach are needed, not dominance from one professional group. As to costs, an examination of the data shows that in relative terms costs for community care tended to increase significantly in the recent past. Yet it is not clear that there has been a transfer from short-term medical and hospital services to long-term care. However, there has been an important internal change in hospital costs, with the elderly representing the only group whose costs are rising. In short, despite the political rhetoric on long-term care for the elderly promoting a community approach, these services' main function is still the surveillance of the vulnerable elderly in both short- and long-term care facilities; adapting the elderly to their environment and the environment to the elderly play a growing, though minor, role in the overall picture of medical and social services.

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 Rural-urban disparities in unmet long-term care needs and the demand for community care services among elderly people in China

2019 ◽  
Author(s):  
Yanbing Zeng ◽  
Lixia Wang ◽  
Liangwen Zhang ◽  
Ya Fang
Keyword(s):  
Rural Areas ◽  
Long Term Care ◽  
Unmet Needs ◽  
Community Care ◽  
Care Service ◽  
Economic Status ◽  
Healthcare Education ◽  
Term Care ◽  
Care Services

Abstract Background: Estimates of unmet needs, as an indicator of future needs for long-term care (LTC) services, have become increasingly crucial policy concerns. This study aimed to examine the urban-rural differences in unmet needs and the demand for community care service among community-dwelling elderly people in China. Methods: The data come from the 2014 Chinese Longitudinal Health Longevity Survey (CLHLS). A total of 1587 community residents aged 65+ with disabilities in the activities of daily living (ADLs) were included in this study. Based on the Andersen theoretical model, binary logistic regression was used to estimate the correlates of unmet needs in LTC. A chi-square test was used to examine the differences in expected needs for community-based LTC services between urban and rural areas. Results: Over half (55.07%) of the participants reported their needs were unmet. Poor economic status and reluctant caregivers seriously affected elderly unmet needs. Among urban older adults, those who were male and lonely reported more unmet needs. Among rural ones, those with severe ADL disability and poor self-rated health reported more unmet needs. In addition, access to medication and home visit services were negatively associated with unmet needs. Living with children (69.12%) was viewed as the most desirable living arrangement among older adults, while living in a LTC facility seemed to be more accepted for rural residents with unmet needs than for other elderly respondents. Residents showed a high demand for community LTC care services, with 82.55% of them expecting to need home visits and 74.29% to healthcare education. Specifically, rural residents had greater expected needs for every community care service than their urban counterparts. However, only 4.66% to 36.42% of the respondents reported that all eight types of services were available, which was far below the demand for these services. Conclusion: The risk of having unmet LTC needs is largely determined by elderly people’s economic status and caregivers’ willingness to provide care for both rural and urban elderly residents. More attention should be paid to psychological consulting services in urban areas, as well as personal care, home visits, psychological consulting and healthcare education services in rural areas.

scholarly journals Healthcare costs for the elderly in Japan: Analysis of medical care and long-term care claim records

PLoS ONE ◽  
2018 ◽  
Vol 13 (5) ◽  
pp. e0190392 ◽  
Author(s):  
Naomi Akiyama ◽  
Takeru Shiroiwa ◽  
Takashi Fukuda ◽  
Sachiyo Murashima ◽  
Kenshi Hayashida
Keyword(s):  
Medical Care ◽  
Healthcare Costs ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care

scholarly journals Factors Influencing Long-Term Care Service Needs among the Elderly Based on the Latest Anderson Model: A Case Study from the Middle and Upper Reaches of the Yangtze River

Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 157 ◽  
Author(s):  
Liao Zeng ◽  
Xiaocang Xu ◽  
Chunxun Zhang ◽  
Linhong Chen
Keyword(s):  
Anderson Model ◽  
Yangtze River ◽  
Long Term Care ◽  
Care Service ◽  
The Elderly ◽  
Service Needs ◽  
The Yangtze River ◽  
Enabling Factors ◽  
Term Care

The rapid growth of population aging makes providing adequate long-term care (LTC) services for the elderly a serious social dilemma in China. Thus, it is necessary to carry out a theoretical discussion on the LTC service needs of the elderly and find out their influencing factors. With four regions of the middle and upper reaches of the Yangtze River as the sample case, this study aims to explore the factors that affect LTC service needs of the elderly in the frame of the latest Anderson Model, which added psychosocial factors to predisposing characteristics, enabling factors, and need factors in the old version. Some interesting results have been found, for example, self-image evaluation is composed of several factors such as general physical health, attitude towards life, or psychosocial states. Finally, sub-analyses—namely, by age, by gender, and by educational level—were carried out since the choice of different long-term care service patterns is related to different age/gender/education groups.

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