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Managing long-term conditions: report supplement: results of the GP and practice nurse surveys
- Author:
- AUDIT SCOTLAND
- Publisher:
- Audit Scotland
- Publication year:
- 2007
- Pagination:
- 31p.
- Place of publication:
- Edinburgh
Results are presented of telephone surveys amongst GPs and practice nurses, with reference to Delivering for Health. The survey aimed to find out their current ways of working, how these ways of working are changing, and attitudes towards proposed new models of care for people with long-term conditions. The survey was carried out in six NHS board areas: Ayrshire and Arran, Borders, Forth Valley, Greater Glasgow and Clyde, Highland and Tayside. For the survey, a letter was sent to each GP, practice nurse and practice manager in every practice in six sample board areas, introducing and explaining the survey and informing them that an interviewer would telephone. The telephone survey of GPs and practice nurses took place over a period of five weeks between 22 August and 26 September 2006.
Key messages: managing long-term conditions
- Author:
- AUDIT SCOTLAND
- Publisher:
- Audit Scotland
- Publication year:
- 2007
- Pagination:
- 4p.
- Place of publication:
- Edinburgh
Services for adults with long-term conditions are examined, focusing on two conditions in particular, COPD and epilepsy. These conditions were selected because there had been little evaluation of these compared with other long-term conditions. Key messages are presented. The study involved analysis of quantitative activity data on long-term conditions, analysis of spend on long-term conditions, and interviews with staff at the SEHD and at a sample of NHS boards (including health professionals specialising in COPD or epilepsy), CHPs and council social work departments. The fieldwork was carried out in six NHS board areas: Ayrshire and Arran, Borders, Forth Valley, Greater Glasgow and Clyde, Highland and Tayside. Focus groups were held with people with COPD or epilepsy in the sample board areas and GPs and practice nurses in the sample board areas were surveyed.
Managing long-term conditions
- Author:
- AUDIT SCOTLAND
- Publisher:
- Audit Scotland
- Publication year:
- 2007
- Pagination:
- 38p.
- Place of publication:
- Edinburgh
Services for adults with long-term conditions were examined, focusing on two conditions in particular: COPD and epilepsy. These conditions were selected because there has been little evaluation of these compared with other long term conditions. The study included analysis of quantitative activity data on long-term conditions, analysis of current spend on long-term conditions, a review of documents and interviews with staff at the SEHD and at a sample of NHS boards (including health professionals specialising in COPD or epilepsy), CHPs and council social work departments, 14 focus groups with people with COPD or epilepsy in the sample board areas, and surveys of GPs and practice nurses in the sample board areas. The fieldwork at boards was carried out in six areas: Ayrshire and Arran, Borders, Forth Valley, Greater Glasgow and Clyde, Highland and Tayside.
Means to an end
- Author:
- DOBSON Alex
- Journal article citation:
- Care and Health Magazine, 5.10.04, 2004, pp.21-23.
- Publisher:
- Care and Health
Reports on the Care Services Efficiency Delivery Programme which aims to provide better adult care services whilst making more effective use of resources. Looks at concerns about how these savings are to be achieved at a time when there are increasing pressures on adult social care services.
Improving outcomes for people with long-term care needs through personalisation
- Authors:
- DOETTER Lorraine Frisina, et al
- Journal article citation:
- Eurohealth, 25(4), 2019, pp.6-9.
- Publisher:
- European Observatory on Health Systems and Policies
- Place of publication:
- Brussels
Population ageing and an associated increase in chronic conditions such as dementia have seen demand for long-term care (LTC) rise, with this trend expected to continue. At the same time, the supply of informal carers is expected to decline, leading to greater reliance on formal provision of LTC. These challenges have prompted strong interest from policymakers in implementing innovative solutions to increase LTC sustainability. One such innovation is delivery of personalisation approaches such as personal budgets, direct cash payments and vouchers. This article explores evidence on effectiveness of personalisation and provides examples of good practice from Europe. (Edited publisher abstract)
Balancing long-term care in Japan
- Authors:
- OHWA Mie, CHEN Li-Mei
- Journal article citation:
- Journal of Gerontological Social Work, 55(7), October 2012, pp.659-672.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The provision of long-term care (LTC) is a major policy issue for countries with an ageing population. Japan is the largest and fastest ageing country in the world, with almost 30 million people over the age of 65, representing 23% of its population. It is predicted that this figure will reach 40% by 2050. This article discusses Japan's long-term care from the perspective of balancing the provision and financing of care. Specifically, this article provides an overview of the long-term care insurance (LTCI) system in Japan, which is financed half by public funds, and half by insurance contributions. It analyses the current state of Japan's LTC with current statistical data as to whether the supply meets the demand for care by frail elders and their families. The article concludes that changes in LTC practices and the bureaucratic system are needed to better deal with the rising care needs.
The future of care funding: time for a change
- Author:
- CARING CHOICES
- Publisher:
- Caring Choices
- Publication year:
- 2008
- Pagination:
- 35p.
- Place of publication:
- London
The UK needs a new system to pay for long-term care for older people, which combines a clear-cut entitlement to care and support with a sharing of costs between individuals and the state. This was the conclusion of a nine-month consultation initiative involving over 700 people with experience of the long-term care system as users, carers, providers or researchers. The Caring Choices initiative was run by a coalition of 15 organisations with an interest in the long-term care system, led by the King’s Fund, Joseph Rowntree Foundation, Help the Aged and Age Concern. Born out of widespread and growing concern that the current system is unsustainable, it encouraged and facilitated debate across England and Scotland and through a series of events and an interactive website
A multidisciplinary, community-based program to reduce unplanned hospital admissions
- Authors:
- WAN Ching Shan, MITCHELL Jade, MAIER Andrea B.
- Journal article citation:
- Journal of the American Medical Directors Association, 22(6), 2021, pp.1331.E1-1331.E9.
- Publisher:
- Elsevier (for the American Medical Directors Association)
Objectives: To evaluate the effect of Hospital Admission Risk Program (HARP) on unplanned hospitalization, bed days, and mortality of enrolled individuals and to evaluate the cost-effectiveness of HARP. Design: A retrospective longitudinal analysis of hospital administrative data. Intervention: Individuals at risk of hospitalization were provided with multidisciplinary, community-based care support managed by care coordinators including integrated care planning, education, monitoring, service linkages, and general practitioner liaison over 6-9 months. Setting and Participants: Individuals who were enrolled into 1 of 8 HARP chronic disease management programs between July 1, 2017, and June 30, 2018, at the Royal Melbourne Hospital, Australia. Methods: Hospital admissions between 18 months before and 18 months after HARP enrollment were analyzed. Total hospital costs were compared between 18 months before and 12 months after HARP enrollment. Results: A total of 1553 individuals with a median age of 71 years (interquartile range 60-81), 63.4% males, were admitted to HARP. Both unplanned hospitalizations and bed days were reduced during the HARP intervention compared to within 3 months before enrollment in each of the HARP management programs. After the HARP intervention, cardiac coach, cardiac heart failure, chronic respiratory, diabetes comanagement, and medication management programs had higher hospitalizations and bed days than individuals’ baseline of at least 3 months before HARP enrollment. Individuals in cardiac heart failure and chronic respiratory management programs had a higher mortality rate than other HARP chronic disease management programs. Individuals in cardiac coach, diabetes comanagement, and medication management programs had lower hospital costs during the HARP intervention compared to within 3 months before HARP enrollment. Conclusions and Implications: HARP reduced unplanned hospitalization and bed days but did not return individuals’ hospital use to baseline before the intervention. The variations in mortality between HARP chronic disease management programs implies that condition-specific goals between programs is preferable. (Edited publisher abstract)
Using a 'wellbeing' cost-effectiveness approach to improve resource allocation in social care
- Authors:
- FORDER Julien, FERNANDEZ Jose-Luis
- Publisher:
- Quality and Outcomes of Person-centred Care Policy Research Unit
- Publication year:
- 2015
- Pagination:
- 22
- Place of publication:
- Canterbury
The main aim of this paper is to contrast a needs-led social care resource allocation system with one using a maximising wellbeing approach; that is, one based on: measuring the wellbeing consequences of using services and applying the principles of cost-effectiveness and opportunity cost. The promotion of wellbeing is the newly-stated guiding principle for the long-term care (social care) system in England. It signals a shift away from a focus on care need ‘deficits’ approach. Such a change in perspective has the potential to substantially alter how public care systems operate. The practical challenges are significant, both in the interpretation of wellbeing goals and in determining how the care system might be configured to achieve them. The paper describes how a maximising wellbeing approach might be applied in the case of long-term care. It argues that in theory a maximising wellbeing approach with full information will produce greater total wellbeing improvement for the same budget than a needs-based system. In practice, the comparison will depend on: (a) whether it is possible to actually measure wellbeing in a way that is consistent with the policy goals; (b) the availability of cost-effectiveness information; and (c) the decision rules used to implement a maximising wellbeing approach. (Edited publisher abstract)
“Many helping hands”: a review and analysis of long-term care policies, programs, and practices in Singapore
- Authors:
- ROZARIO Philip A., ROSETTI Amanda Leigh
- Journal article citation:
- Journal of Gerontological Social Work, 55(7), October 2012, pp.641-658.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article, using the political economy perspective to examine key long-term care policies and provisions, explores ideological underpinnings of policy-making in Singapore. Family involvement, an inherent part of the long-term care system, is overtly reinforced by legislations and policy imperatives. Further, the government encourages and expects the participation of non-state actors in the provision of services as part of its Many Helping Hands approach to welfare provision. The article argues that the government's emphasis of certain ideology, such as self-reliance and cultural exceptionalism, allows it to adopt a residual and philanthropic approach in support of its macro-economic and legitimacy concerns. The authors concluded that Singapore should consider a westernised approach to long-term care needs that are more fiscally conservative in nature.