scholarly journals Cost-Utility Analysis of Malaysian Elderlies Living in Public Long-Term Care Institutions

2021 ◽  
Vol 29 (4) ◽  
pp. 2389-2400
Author(s):  
Syazreen Niza Shair ◽  
Thomas Sachi Purcal
Keyword(s):  
Nursing Home ◽  
Residential Care ◽  
Long Term Care ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Nursing Home Care ◽  
Utility Analysis ◽  
Term Care ◽  
The Cost

This research compares the quality of life of Malaysian elderlies living in public formal long-term care institutions, including residential care and nursing home care. It provides evidence of the cost-effectiveness of both programs. The sample of Malaysian elderlies aged 60 years and above was collected from the World Health Survey, including five dimensions of health status: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression. Each of the dimensions has three levels, including 1 (“no problems”), 2 (“some problems”) and 3 (“major problem”). The quality-adjusted life-years (QALYs) of elderlies living in both institutions are estimated using a generic health-related measurement method, EQ-5D. In addition, cost-utility analysis is adopted to compare the effectiveness of programs in allocating resources. The QALY of those living in nursing home care is reasonably lower than those in residential care due to their worse chronic health conditions. The majority are categorised as severely disabled. The cost-effectiveness evaluation of each public long-term care model suggests that the residential care program is cost-effective, with the cost per QALY being MYR22 945. At the same time, a nursing home for disabled people is not effective as the cost per QALY is MYR57 822, falls outside the willingness to pay (WTP) range between (MYR 19,929–MYR 28,470).

The vulnerability of nursing home residents to the Covid-19 pandemic

2020 ◽  
Vol 23 (2-3) ◽  
pp. 57-60 ◽  
Author(s):  
Edward H Wagner
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Nursing Assistants ◽  
Nursing Home Care ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.

scholarly journals Municipalities’ Decision to Care: At Home or in a Nursing Home

2020 ◽  
Vol 26 (4) ◽  
pp. 327-342
Author(s):  
Theis Theisen
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Long Term Care ◽  
Nursing Home Care ◽  
Empirical Literature ◽  
Term Care ◽  
Scant Attention ◽  
Insurance Mechanism ◽  
Using Data

AbstractAn almost ideal demand system for long-term care is estimated using data from Norway, where the split of long-term care between home care and care in nursing homes is determined by municipalities. Previous literature has barely addressed what determines municipalities’ or other organizations’ allocations of resources to the sub-sectors of long-term care. The results show that home care is a luxury, while nursing home care is a necessity with respect to total expenditures on long-term care. Municipalities respond to high unit costs for home care by reducing that type of care. Municipalities are highly responsive to variations in the need for the two types of care and seem to provide a well-functioning insurance mechanism for long-term care. In the previous empirical literature, municipalities’ role as providers of insurance against the consequences of disabilities and frailty has received scant attention.

Physical Health and Cognitive Ability Among Married Long-Term-Care Patients and Among Their Spouses—A Comparison Between Home Care and Nursing Home Care

1993 ◽  
Vol 5 (2) ◽  
pp. 157-168 ◽  
Author(s):  
Ann-Christine Löfgren ◽  
Gösta Bucht ◽  
Sture Eriksson ◽  
Tage Lundström
Keyword(s):  
Nursing Home ◽  
Cognitive Function ◽  
Nursing Homes ◽  
Home Care ◽  
Physical Health ◽  
Long Term Care ◽  
Nursing Home Care ◽  
Term Care ◽  
Nursing Home Patients

The purpose of this study was to establish whether physical health and cognitive function in married long-term patients or in their spouses determines why some patients are cared for in home care while others reside in nursing homes. Out of 38 married couples with a sick spouse cared for in a nursing home, 23 couples were studied; out of 34 couples with a sick spouse cared for in home care, 22 patients and 25 spouses were studied. The results showed no significant differences in physical health score either between the two groups of patients, or between the two groups of spouses. Both home-care patients and nursing home patients had low cognitive function scores, but nursing home patients had significantly lower scores. A multivariate analysis showed that physical health and cognitive function explained only 20% of patients' residence. Between the two groups of spouses there was no difference in cognitive function score. The conclusion is that physical health status and cognitive function explain only to a small extent why married long-term care patients are cared for in nursing homes or in home care.

scholarly journals Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

2016 ◽  
Vol 8 (3) ◽  
pp. 329-343
Author(s):  
Jingping Xing ◽  
Dana B. Mukamel ◽  
Laurent G. Glance ◽  
Ning Zhang ◽  
Helena Temkin-Greener
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Long Term Care ◽  
Nursing Home Care ◽  
Term Care ◽  
Medicaid Reimbursement ◽  
Quality Of Nursing

Effizienzreserven in der stationären Pflege in Deutschland: Versuch einer Quantifizierung und Implikationen für die Reform der Gesetzlichen Pflegeversicherung

2008 ◽  
Vol 57 (1) ◽  
Author(s):  
Jasmin Häcker ◽  
Birgit König ◽  
Bernd Raffelhüschen ◽  
Matthias Wernicke ◽  
Jürgen Wettke
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
Long Term Care ◽  
Nursing Home Care ◽  
Term Care ◽  
Consumer Sovereignty ◽  
Incentive Problem ◽  
Relationship Of

AbstractThe design of the German statutory long-term care insurance (LTCI) is deficient in many respects. One of the major flaws in nursing home care is the inherent incentive problem concerning the relationship of the insured, the insurers and the nursing homes: For one, there is no competition amongst the insurers which influences the negotiation behaviour towards the nursing homes concerning the fixing of the daily payment rates. The nursing homes in turn are more or less unrestricted at setting the daily payment rate as the insured are mostly not in a position to fully practice their consumer sovereignty in case of the need of long-term care treatment. In the framework of this paper we try to quantify the efficiency reserve behind these disincentives in nursing home care and try to assess to what extent the contribution rate to LTCI could be reduced, if the efficieny reserves were exhausted.

Older couples and long-term care: the financial implications of one spouse entering private or voluntary residential or nursing home care

1999 ◽  
Vol 19 (2) ◽  
pp. 209-237 ◽  
Author(s):  
RUTH HANCOCK ◽  
FAY WRIGHT
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Residential Care ◽  
Married Couples ◽  
Nursing Home Care ◽  
Local Authorities ◽  
Term Care ◽  
Care Costs ◽  
At Home

A minority of older people who move into long-term institutional care are married and have spouses who continue living in the community. The financial complexities and consequences for a couple in this situation deserve to be more widely recognised. Data from the Family Expenditure Survey on the incomes of older married couples are used to examine the financial implications for couples of one spouse entering residential or nursing home care, taking into account local authority procedures for assessing residents' contributions to charges and Income Support rules as they apply to both spouses. We look in particular at the consequences of alternative ways couples might share their incomes, and alternative treatments of such sharing by local authorities and the Department of Social Security. We demonstrate that wives remaining at home are more likely to have low incomes and have recourse to means-tested state benefits if their husbands enter residential care than husbands who remain at home when their wives enter care. Local authorities are likely to be able to require larger contributions to their care costs from husbands than wives. On average, wives whose husbands enter residential care are best off financially when their combined income and savings are shared equally, but this leaves husbands with the least money to contribute to their care costs. If it is the wife who enters care the situation is reversed.

A Comparison between the Veteran Administration's Long-Term Nursing Home Care Program and Three Examples of Similar Care Outside of the V.A.

1981 ◽  
Vol 13 (1) ◽  
pp. 61-69 ◽  
Author(s):  
William M. Epstein
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Nursing Care ◽  
Long Term Care ◽  
Care Program ◽  
Nursing Home Care ◽  
National Academy Of Sciences ◽  
Term Care

In a study mandated by Congress, the National Academy of Sciences reviewed the quality of medical care in the Veteran's Administrations health care system. The study reported here summarizes the findings of the long-term care portion of the NAS' work as it relates to nursing home care. The quality of the long-term care in the VA's nursing home care units was compared to three quality standards of long-term nursing care outside of the VA. Staffing pattern, quality of services, quality of the environment, and patient needs were measured and compared; overall assessments of nursing home quality were made by site visitors. Generally, the results show VA care to be superior to the care provided in the benchmark institutions, suggesting perhaps that the public sector's direct provision of long-term nursing care may be an acceptable alternative to the support of private sector care.

Are Personal Budgets a Financially Sound Reform Option for the German Long-Term Care Insurance?

2010 ◽  
Vol 230 (4) ◽  
Author(s):  
Melanie Arntz ◽  
Stephan L. Thomsen
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Long Term Care ◽  
Cost Savings ◽  
Nursing Home Care ◽  
Term Care ◽  
Long Run ◽  
Long Term Care Insurance ◽  
The Stability

SummaryIn a long-run social experiment, personal budgets have been tested as an alternative home care program of the German long-term care insurance (LTCI). By granting the monetary value of in kind services in cash, personal budgets are considered to enable customized home care arrangements, thereby avoiding costly nursing home care and thus saving LTCI spending. However, personal budgets also compete with the already existing and less generous cash option of the LTCI. Any transition from the receipt of cash benefits to personal budgets thus challenges the view of personal budgets as a cost savings device, unless personal budgets sufficiently reduce the use of costly nursing home care to balance these extra costs.This paper therefore contrasts the short-term costs of implementing personal budgets with potential cost savings if personal budgets enhance the stability of home care and avoid costly nursing home care. For this purpose, the paper investigates the effects of personal budgets on the duration of home care until moving to a nursing home as well as the perceived stability of home care. Despite a positive effect of personal budgets on the stability of home care, LTCI spending is likely to increase in the short to medium run. In the long run, however, the expected transition to decreasing numbers of cash recipients favors the introduction of personal budgets.

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