scholarly journals Experiences with the privatization of home care: evidence from Denmark

2011 ◽  
Vol 2 ◽  
Author(s):  
Barbara Fersch ◽  
Per H Jensen
Keyword(s):  
Welfare State ◽  
Home Care ◽  
Central Government ◽  
Elderly Care ◽  
The Elderly ◽  
Care Providers ◽  
Public And Private ◽  
Political Actors ◽  
Financial Responsibility ◽  
Care For The Elderly

Processes of privatization in home care for the elderly in Denmark have primarily taken the form of outsourcing public-care provisions. The content and quality of services have in principle remained the same, but the providers of services have changed. The welfare state has continued to bear the major responsibility for the provision of elderly care, while outsourcing has allowed clients to choose between public and private providers of care. The major aim of outsourcing has been to empower the frail elderly by providing them with exit-opportunities through a construction of this group as consumers of welfare-state provisions. The central government in Denmark has produced the public-service reform, but the municipalities bear the administrative and financial responsibility for care for the elderly. Further, national policymakers have decided that local authorities (municipalities) must provide to individuals requiring care the opportunities to choose. With this background in mind, this article analyses how national, top-down ideas and the ‘politics of choice' have created tensions locally in the form of municipal resistance and blockages. The article draws on case studies in two Danish municipalities, whereby central politicians and administrative leaders have been interviewed. We have identified four areas of tensions: 1) those between liberal and libertarian ideas and values versus local political orientations and practices; 2) new tensions and lines of demarcation among political actors, where old political conflicts no longer holds; 3) tensions between promises and actual delivery, due to insufficient control of private contractors; and 4) those between market principles and the professional ethics of care providers.

Aged Care Services in India

2021 ◽  
pp. 114-143
Author(s):  
Wadad Kathy Tannous ◽  
Divya Ramachandran
Keyword(s):  
Filial Piety ◽  
Elderly Care ◽  
The Elderly ◽  
Aged Care ◽  
Geriatric Care ◽  
Term Care ◽  
Public And Private ◽  
Care Services ◽  
Care For The Elderly ◽  
The Government

India is the world's largest democracy and second most populous country with nearly 1.4 billion people. With reduced birth rates and increasing lifespans, it had nearly 104 million ‘senior citizens' in 2011, expected to grow to 300 million by 2050. Providing care for the elderly in India is a growing public and private concern. Filial piety is embedded in culture and long-term care for parents and the elderly is expected from children. However, over the last five decades there have been rapid changes in socioeconomic patterns with increasing mobility for work and rise of nuclear households. Despite this, elder care is still largely underdeveloped, with lack of formal training in geriatric care and geriatric care curriculum in medical education. Australia has a highly evolved elderly care system with care services that includes retirement villages, home care, residential care, and flexible care. These are provided by subsidization from the government and private user pay system. Australia is well poised to provide aged care expertise and services and shape elderly care in India.

The professionalisation of domiciliary care for the elderly: a comparison between public and private care service providers in Belgium

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chiara Giordano
Keyword(s):  
Home Care ◽  
Service Providers ◽  
The Elderly ◽  
Home Care Services ◽  
Care Providers ◽  
Public And Private ◽  
Content Type ◽  
Private Care ◽  
The Public ◽  
Care Services

PurposeThe objective is to explore how the professionalisation of care jobs is constructed in the public and private sectors and to discuss whether the instruments used by public and private care providers contribute to solve the ambiguities linked to this type of work and which are the consequences for caregivers.Design/methodology/approachThis paper compares the way in which the professionalisation of home care services for elderly people is achieved in the public and private sectors in the region of Brussels. The findings are based on the analysis of interviews with professional actors working in the care sector in Brussels.FindingsThe analysis shows that there is no agreement over the best way of professionalising home care services for the elderly and that the efforts made by public and private providers are profoundly different.Originality/valueThe divergencies are not only the result of the strict institutional framework to which public care providers are bound, in opposition to the relative freedom of the private sector, but they also derive from a different understanding of care work.

HOME CARE IN OUTPATIENT CARE – STATE AND DEVELOPMENT IN BULGARIA

2018 ◽  
Vol 28 (2) ◽  
pp. 571-574
Author(s):  
Ivanka Stambolova ◽  
Stefan Stambolov
Keyword(s):  
Home Care ◽  
Outpatient Care ◽  
Care Service ◽  
Elderly Care ◽  
Care Center ◽  
Elderly Person ◽  
Chronically Ill ◽  
The Elderly ◽  
Legal Regulation ◽  
Health And Social Care

In outpatient care the home care, including hospices, is recognized as a model for providing quality, cost-effective and charitable care. The focus is mainly on the care that helps everyday lifeof the patient as well as the relatives, rather than on treatment, and in most cases it takes place in the patients' home. In Europe, in recent years there has been a real "boom" in home care due to demographic processes linked to increased needs for elderly care and chronically ill under the conditions of limited financial resources.In outpatient medical care in our country by means of a national framework contract there are regulated visits to the patient's home by a doctor, as well as visits by medical staff employed by him - nurse, midwife, medical assistant / paramedic / for manipulation, counseling and monitoring. At the same time there is no regulated legal activity in the Republic of Bulgaria, which is essentially the subject of home care.Since 1994 „Caritas“ has carried out the "Home Care" service, which provides a complex - health and social care for over 360 sick adults in a place where the elderly person feels the most comfortable - in their own home. „Caritas Home Care“ is provided by mobile teams of nurses and social assistants who visit the elderly at home and provide them with the necessary care according to their health and social needs.With the establishment of the first „Home Care Center“ in Lozenets region, Sofia, with the support of the PHARE ACCESS program in 2003, the Bulgarian Red Cross introduces in Bulgaria an integrated model for provision of health care and social services in the home of adults, chronically ill and people with permanent disabilities. To date, there are a number of problems in home care related to the realization of home care for patients in need in out-of-hospital settings: lack of legal regulation for home care, lack of qualified staff in outpatient care; lack of organization and structures for care; unsettled funding and the inability of the part of the population that is most in need of care to pay for it, there is no regulation to control the activity. Although home care began over 20 years ago, our country is yet to make its way to the European program called „Home care in Europe“.

The economics of home care for the elderly

1986 ◽  
Vol 1 (2) ◽  
pp. 94-103
Author(s):  
C. Bielawska ◽  
G.S. Rai
Keyword(s):  
Home Care ◽  
The Elderly ◽  
Care For The Elderly

scholarly journals Analysis of the Contribution of Small Residential Care Centers for the Elderly to reduce the Socio Environmental Impact and Foster Entrepreneurship in Brazilian Megacities (São Paulo)

2016 ◽  
Vol 7 (3) ◽  
pp. 103 ◽  
Author(s):  
Heloisa Candia Hollnagel ◽  
Luiz Jurandir Simões De Araújo ◽  
Ricardo Luiz Pereira Bueno
Keyword(s):  
Business Models ◽  
Elderly Care ◽  
Care Center ◽  
Life Quality ◽  
The Elderly ◽  
Work Place ◽  
Decent Work ◽  
Urban Centers ◽  
Public And Private ◽  
Peripheral Areas

On 2016 the 17 United Nations Sustainable Development Goals (SDGs) of the 2030 Agenda officially came into force proposing that Governments can work to promote inclusive and sustainable economic growth, employment and decent work for all. This study aims to analyze the contribution of Residential Elderly Care Center – RECC to promote SD along with social support in urban centers of megacities. Considering that the current scenario presents: longer life expectancy and increasing numbers of older people; the growing presence of women in the market and the hierarchy of companies making more and more difficult for them to stay at home as well as the failure of public care structure to respond adequately to citizens’ demands new business models are welcome. While the families are getting smaller which removes potential caregivers within them, conversely mobility issues among peripheral areas and public institutions are increasing. Large arrangements for caring can be useful in some contexts, but generally, require commuting from home to the support structure and new public and private investments. The potential reduction of human daily dislocations could improve the environment and life quality in megacities in many aspects: decreasing vehicles CO2 emissions, pollution and the volume of traffic; giving practicality to everyday life of families with dependent members of care and generating new opportunities of small business. In addition, this new residential structures employment might reduce the need to shift the caregivers themselves to their work place, strengthen community bounds and not require immobilization of new properties of the exclusive use for Care centers in highly urbanized areas. The methodology used in this paper is based in the exploratory-descriptive and bibliographical-documentary method. Results of the study are corroborated by a series of complementary research of the authors. Conceptual step-by-step flowchart to assist an entrepreneur to open a RECC is described.

Patterns of Expenditure in Healthcare for Elderly in Shanghai

China Report ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 334-353
Author(s):  
Zhu Bifan ◽  
Li Fen ◽  
Wang Linan ◽  
Wang Changying ◽  
Jin Chunlin
Keyword(s):  
Elderly Care ◽  
Age Groups ◽  
The Elderly ◽  
Pattern Of Care ◽  
Younger Adults ◽  
Care For The Elderly ◽  
The Status ◽  
Integration Of Services ◽  
Health Accounts ◽  
System Of Health Accounts

This study aims to summarise the characteristics of elderly care system and analyse expenditures of healthcare for the elderly in Shanghai. The authors use medical records of 2015 and health account results of 2014 based on System of Health Accounts 2011 to describe the pattern of care expenditures for elderly. Individuals aged 60 years and above account for 19.5 per cent of Shanghai’s population but utilise 52.2 per cent of all outpatient visits and 45.3 per cent of all hospitalisations. Almost two-thirds of their medical expenditures occur in hospitals and 16 per cent in community health centres, corresponding to the status of resource allocation. The out-of-pocket payment ratio of the elderly is lower than that of the younger adults, which is attributable to the preferential reimbursement polices set by the insurance schemes. The leading causes of expenditures are cardiovascular disease, neoplasms and respiratory diseases. Care for the elderly costs more, and the elderly use more services than other age groups. The article recommends the monitoring of irrational utilisation of services, strengthening of primary level care and integration of services across different facilities to streamline care for elderly in Shanghai.

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