The Transformation of the Municipal Social Care System in Hungary – In the Light of the Provision of Home Care Services

2020 ◽  
Vol 18 (4) ◽  
pp. 691-712
Author(s):  
Andrea Szatmari ◽  
Istvan Hoffman
Keyword(s):  
Social Services ◽  
Local Governments ◽  
Social Care ◽  
Home Care Services ◽  
Mixed System ◽  
Economic Power ◽  
Central Regulation ◽  
Care Services ◽  
Central Support ◽  
Basic Services

Municipalities play a significant role in the field of social care services. The basic social services are primarily provided by local governments. The Hungarian municipalities have strong social powers and duties, but their role is in a permanent transformation. The strongly decentralised system established in the early 1990s has since been centralised and the majority of specialised social services has been nationalised in the last decade. This has resulted in a new model; a mixed system having evolved after 2013. The provision of the specialised services has been mainly centralised, while the basic services have remained the responsibility of the municipal bodies. In this article, the impacts of this reform are analysed. The centralisation of the specialised services and the reforms of the financial support of municipal basic social services significantly transformed the former accessibility. The accessibility to these services depends on several factors: it depends on the central regulation of the entitlement rules, of the central funding of the municipal tasks and partly that of the economic power of the municipality. The central regulation and the central support of these services play a very important role in this system.

Resource Allocation Modelling for Home-Based Health and Social Care Services in Areas Having Differential Population Density Levels: A Case Study in Northern Ireland

2000 ◽  
Vol 13 (3) ◽  
pp. 164-169 ◽  
Author(s):  
Tony Hindle ◽  
Adam Hindle ◽  
Martin Spollen
Keyword(s):  
Resource Allocation ◽  
Northern Ireland ◽  
Social Services ◽  
Social Care ◽  
Geographical Information ◽  
Population Densities ◽  
Relative Population ◽  
Care Services ◽  
Home Based ◽  
Health And Social Care

This project arose from deliberations within the Department of Health and Social Services (DHSS) in Northern Ireland concerning the acceptability of the revenue resource allocation methodology they were using. One problem with the method being used had been the absence of a component that adequately reflected the relative costs associated with the differential population densities of the four health boards into which the Province is divided. This study investigates a particular element of this issue, viz differences in the travelling distances and times of those health and social service professionals who provide visiting services to patients in their own homes. A modelling approach has been developed and used in conjunction with a comprehensive spatial and geographical information system for Northern Ireland. An important outcome of the study has been estimates of the targets that should be set for the annual health and social care travelling distances and times per head of population in the boards, for a range of home-based services. Also, the project has contributed to decisions made by the DHSS in Northern Ireland concerning the annual financial compensations required by boards for costs associated with their relative population densities.

scholarly journals Does sector matter for the quality of care services? A secondary analysis of social care services regulated by the Care Inspectorate in Scotland

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e022975 ◽  
Author(s):  
Anders Malthe Bach-Mortensen ◽  
Paul Montgomery
Keyword(s):  
Logistic Regression ◽  
Social Services ◽  
Social Care ◽  
Secondary Analysis ◽  
Third Sector ◽  
Low Risk ◽  
Care Providers ◽  
For Profit ◽  
Care Services ◽  
Better Than

ObjectivesSocial services are increasingly commissioned to third and for-profit sector providers, but little is known about whether and how these changes influence quality indicators. We assessed quality-related outcomes across for-profit, public and third sector organisations delivering social care services.DesignA secondary analysis was conducted on publically available data collected by the independent regulator of social care organisations in Scotland. All outcomes are reported as predicted probabilities derived from multivariate logistic regression coefficients. Generalised ordered logit models are utilised for the quality domains and the risk assessment score and logistic regression for whether complaints or requirements were issued to organisations.SettingOrganisations inspected by the Care Inspectorate in Scotland.Population13 310 social care organisations (eg, nursing homes and day care organisations).Primary outcomesThe quality and risk domains collected by the Care Inspectorate and complaints and requirements issued to organisations within the last 3 years.ResultsControlling for multiple factors, we find that public and third sector providers performed consistently and statistically significantly better than for-profit organisations on most outcomes. For example, for-profit services were the most likely to be rated as high and medium risk (6.9% and 13.2%, respectively), and the least likely to be classified as low risk (79.9%). Public providers had the highest probability of being categorised as low risk (91.1%), and the lowest probability of having their services classified as medium (6.9%) and high risk (2%), followed by third sector providers (86%, 8.5% and 4.5%, respectively). Public providers performed better than third sector providers in some outcomes, but differences were relatively low and inconsistent.ConclusionPublic and third sector providers were rated considerably higher than their for-profit counterparts on most observed outcomes. Regulators might use this information to consider how social care providers across sector are incentivised to manage their resources.

Some Thoughts on the System of Tasks of the Local Autonomies Related to the Organisation of Personal Social Care

2012 ◽  
Vol 10 (4) ◽  
Author(s):  
István Hoffman
Keyword(s):  
Social Services ◽  
Local Governments ◽  
Social Care ◽  
Local Communities ◽  
Short Description ◽  
The State ◽  
The Social ◽  
Post Industrial ◽  
Industrial Societies

In the modern post-industrial societies services are becoming the greatest part of the economy, and through the reallocating role of state – even after the millennium changes – the role of the services organised by the communities is exceptionally high. One of these services is the social care granted by the state and (its parts) the local governments. In my article I summarise the roles of local communities and local governments of some European and non-European states in the organisation of social care. The practical and theoretical legal terms of social assistance and personal social services are presented as well as the general characteristics of models (settlement or regional municipality based) of the organisation of the services. There is also a short description of general financing issues.

scholarly journals ‘Active ageing’: a qualitative study in six Caribbean countries

2009 ◽  
Vol 30 (1) ◽  
pp. 79-101 ◽  
Author(s):  
PATRICK CLOOS ◽  
CAROLINE F. ALLEN ◽  
BEATRIZ E. ALVARADO ◽  
MARIA VICTORIA ZUNZUNEGUI ◽  
DONALD T. SIMEON ◽  
...  
Keyword(s):  
Social Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Social Protection ◽  
Economic Status ◽  
Home Care Services ◽  
Active Ageing ◽  
Socio Economic Status ◽  
Care Services ◽  
Urban And Rural Areas

ABSTRACTThe aim of this study was to document the perceptions of elders in six Caribbean countries about ‘active ageing’ and on the basis of their reports to make recommendations to improve their situation. Data were collected principally through 31 focus group discussions conducted in both urban and rural areas. Comparative analysis was carried out of the qualitative information, focusing on three components of ‘active ageing’: health and social services access and use, social support, and economic circumstances. Most of the participants were women, aged 60–79 years, of lower socio-economic status and from urban areas. Large disparities in the responses of Caribbean societies to population ageing were indicated, as well as unequal opportunities to obtain health care and social services, public transport, income and food by both socio-economic status and location. Home-care services are either insufficient or non-existent. Some elders receive social and financial support from relatives while others fear isolation and face deprivation. Social participation varies by place, physical condition, financial situation, association membership, and transport opportunities. Social protection benefits do not provide adequate income and some older people face food insecurity. It was concluded that a comprehensive and multi-sectoral approach using the ‘active ageing’ framework should be implemented to ensure a healthy ageing process.

scholarly journals The impact of social care expenditure at the end of life: a novel linkage study in Scotland

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Claudia Geue ◽  
Olivia Wu ◽  
Terry J Quinn ◽  
Alastair Leyland ◽  
Jim Lewsey
Keyword(s):  
Home Care ◽  
End Of Life ◽  
Inpatient Care ◽  
Social Care ◽  
Home Care Services ◽  
Population Ageing ◽  
Service Utilisation ◽  
Care Services ◽  
Utilisation Data ◽  
The Impact

ABSTRACTBackgroundAnalyses of inpatient care admissions have shown that population ageing does not lead to an increase in future healthcare expenditure to the extent that might be expected and that remaining time to death (TTD) is an equally important cost element. But as people live longer and the onset of disease and death are postponed to older ages the utilisation of social care services is another major cost component for elderly people, in particular those with chronic diseases. However, there is a distinct lack of social care data in Scotland to estimate the impact of population ageing and TTD on social care expenditure. ObjectivesThis study aims to estimate the utilisation and associated costs of inpatient and home care services among end-of-life patients. It will also determine the feasibility of undertaking the linkage of home care service utilisation data, inpatient care episodes and death records. MethodsNHS Greater Glasgow and Clyde (NHSGGC) social home care data (Cordia), Scottish Morbidity Records (SMR01) and death records (National Records for Scotland, NRS) will be utilised in order to estimate utilisation and costs for home care services and inpatient care at the end of life. The ‘Cordia’ data is available for the period September 2013 to November 2013 and includes information on the type, duration and frequency of home care services utilised. Costs will be assigned using ‘Personal Social Services Research Unit’ (PSSRU) costs. Using multilevel modelling techniques the association between TTD, age, demographic and socio-economic measures and expenditure on home care services will be estimated, while allowing the effect of covariates to vary over hierarchical levels, such as episode of care and the patient. Expected OutcomesThe wider literature suggests that contrary to inpatient care, costs at the end of life for the oldest old might be higher when considering elements of social care provision. The ‘Cordia’ data consists of 7,367 individuals with 1,620 observed deaths. Further results are forthcoming and findings will significantly add to the knowledge base in the area of population ageing and related health- and social care expenditure. This is a novel linkage and given the difficulties in obtaining social care data, this study will i) help to evaluate the feasibility of using these data for research, and ii) identify where costs at the end of life occur, thus facilitating more targeted approaches to end-of-life care.

scholarly journals The Use of Internet-Based Health and Care Services by Elderly People in Europe and the Importance of the Country Context: Multilevel Study (Preprint)

2019 ◽  
Author(s):  
Sebastian Merkel ◽  
Moritz Hess
Keyword(s):  
Digital Divide ◽  
Elderly People ◽  
Social Services ◽  
Social Care ◽  
The Internet ◽  
Health And Social Services ◽  
Care Services ◽  
Country Level ◽  
Health And Social Care ◽  
Use Of Internet

BACKGROUND Digital health care is becoming increasingly important, but it has the risk of further increasing the digital divide, as not all individuals have the opportunity, skills, and knowledge to fully benefit from potential advantages. In particular, elderly people have less experience with the internet, and hence, they are in danger of being excluded. Knowledge on the influences of the adoption of internet-based health and care services by elderly people will help to develop and promote strategies for decreasing the digital divide. OBJECTIVE This study examined if and how elderly people are using digital services to access health and social care. Moreover, it examined what personal characteristics are associated with using these services and if there are country differences. METHODS Data for this study were obtained from the Special Eurobarometer 460 (SB 460), which collected data on Europeans’ handling of and attitudes toward digital technologies, robots, and artificial intelligence, including data on the use of internet-based health and social care services, among 27,901 EU citizens aged 15 years or older. Multilevel logistic regression models were adopted to analyze the association of using the internet for health and social care services with several individual and country-level variables. RESULTS At the individual level, young age, high education, high social class, and living in an urban area were positively associated with a high probability of using internet-based health and social services. At the country level, the proportion of elderly people who participated in any training activity within the last month was positively associated with the proportion of elderly people using these services. CONCLUSIONS The probability of using internet-based health and social services and their accompanying advantages strongly depend on the socioeconomic background. Training and educational programs might be helpful to mitigate these differences.

Carers’ experiences accessing information on supports and services: Learning the social care “dance”

2017 ◽  
Vol 17 (6) ◽  
pp. 832-848 ◽  
Author(s):  
Kylie Meyer
Keyword(s):  
Local Governments ◽  
Information Needs ◽  
Social Care ◽  
Local Level ◽  
Information Services ◽  
Care Services ◽  
The Social ◽  
Informal Carers ◽  
Services And Supports ◽  
Care System

Cities across England will see a growing number of informal carers as the population ages, many of whom do not begin this role equipped with the knowledge they need to access social care services and supports. One of the more significant changes brought by passage of the Care Act of 2014 is local governments’ increased responsibility to improve the provision of information and advice on social care to informal carers, long recognized as a policy priority. To better understand where improvements can be made on a local level in order to achieve the goals laid out in the Care Act, this study considers carers’ experiences accessing information and advice on social care services and supports in a city with a population of over 250,000 in the south of England. This was done through the collection of semi-structure qualitative interviews with 11 carers to people aged 65 and older from April 2015 to July 2015. Thematic analysis of interviews revealed a tension between carers’ varying levels of knowledge and experience with the social care system and information services’ one-size-fits-all approach to providing information. Findings suggest local governments should focus on creating information services that more actively reach out to carers, provide greater guidance to those carers who need it, and work to flexibly meet informal carers information needs, acknowledging that some carers will be less familiar than others with aspects of the social care system.

Information Technology Supporting Healthcare and Social Care Services

2014 ◽  
Vol 7 (1) ◽  
pp. 41-58 ◽  
Author(s):  
Maria Manuela Cruz-Cunha ◽  
Ricardo Simoes ◽  
João Varajão ◽  
Isabel Miranda
Keyword(s):  
Information Technology ◽  
Special Needs ◽  
Social Services ◽  
Social Care ◽  
Pilot Project ◽  
Full Scale ◽  
Needs Analysis ◽  
User Needs ◽  
Care Services ◽  
The North

The authors are developing a pilot project for a Municipality in the North of Portugal, envisaging the definition and implementation of an e-marketplace for healthcare and social services, in order to facilitate the interaction between healthcare and social services professionals and people with special needs (or their relatives). Based on the results of a survey on user needs analysis and expectations conducted in 2011, the paper discusses the relevance and interest of such platforms and the main drivers and motivations of the population for using such services, as well as which services would motivate citizens to use the platform. The results of the study will be used to select the products and services perceived to be the most desired by the potential users. The paper thus makes three main contributions: (1) the results of the study confirm the interest and the perceived potential of such a service, from the end-users perspective; (2) the findings support the advantage of expanding this pilot project to a full scale implementation; and (3) the performed analysis improves our understanding of the relations between the characteristics of the inquired population and the perceived interest in such platforms.

Health, Healthcare and Ageing Populations in Europe, a Human Rights Challenge for European Health Systems

2016 ◽  
Vol 23 (5) ◽  
pp. 435-452 ◽  
Author(s):  
Henriette Roscam Abbing
Keyword(s):  
Social Services ◽  
Health Systems ◽  
Local Governments ◽  
Health Care Systems ◽  
The Elderly ◽  
Care Services ◽  
Innovative Solutions ◽  
Care Systems ◽  
European Health ◽  
Ageing Populations

Demographic changes (ageing populations) are a challenge for European health systems. Innovative solutions must ensure elderly patients equitable access to good quality, affordable healthcare. De-centralisation and de-institutionalisation in healthcare for the elderly have become policy priorities for European countries. Local governments must have sufficient experience for the necessary integration of health and social services. New ways of looking at health care systems are necessary for reasons of quality, accessibility, and costs-effectiveness. The implementation and co-ordinated monitoring of the health- and care rights of the aged in Europe should be given full attention. There needs to be a handbook on elderly as well as an ombudsman. The exchange of experiences and best practices, oversight of the quality and effectiveness of the health- and care services and the system as such are indispensable.

Mental Health and Social Care Providers Facing Requests of Assisted suicide from Elderly in Nursing Homes in Switzerland

2017 ◽  
Vol 41 (S1) ◽  
pp. S11-S12
Author(s):  
D.A. Castelli Dransart ◽  
S. Voélin ◽  
S. Elena
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
Assisted Suicide ◽  
Social Care ◽  
Home Care Services ◽  
Care Providers ◽  
Care Services ◽  
Health And Social Care ◽  
Competing Interest

IntroductionIn some Swiss states, right-to-die associations are allowed to assist older people in nursing homes provided that certain requirements are fulfilled.ObjectivesTo investigate how health and social care providers and their institutions reacted to and dealt with requests of assisted suicide.MethodAn exploratory qualitative study was carried out in the States of Fribourg and Vaud among 40 professionals working in nursing homes, home care services or social welfare agencies.ResultsThe requests of assisted suicide questioned the professional mission, the quality of accompaniment provided to the older people and both professional and personal values. Health and social care providers were required to ponder over ethical dilemmas or decisions. Several challenges were reported, such as: taking into account and articulating personal freedom or needs with collective functioning or organizational constraints before, during and after the assisted suicide; reconciliating self-determination with protection towards vulnerable people (beneficere, non maleficere).ConclusionsAssisted suicide challenges and changes professional end-of-life practices. Education and support should be provided to health and social care providers faced with it.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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