Search results for ‘Subject term:"long term care"’ Sort:
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The impact of devolution: long-term care provision in the UK
- Author:
- BELL David
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2010
- Pagination:
- 41p., bibliog.
- Place of publication:
- York
This report on long-term care provision policies, from a series on the impact of 10 years devolved government in the United Kingdom, considers the constraint that tax and benefit structure (control of which remains centrally within the Departmental Expenditure Limits (DEL) system), has on Scotland, Northern Ireland, Wales and England. The importance of having secondary social care, funded from Annually Managed Expenditure by the Department for Work and Pensions (DWP) and less bound to annual budgets than DEL, in minimising diversity of delivered care is discussed. The inability of devolved governments to steer DWP, due to weak intergovernmental relations, is highlighted and in section 2 Scottish attendance allowances and Welsh domiciliary care charges are contrasted. Section 3 details demand for care varies more within countries than between them, while section 4 highlights divergence in older people’s ability to pay. A current snapshot of care provision across the UK in section 5, is followed by a focus on free personal care, personalisation and charging in Section 6. Section 7 reiterates that policies can be constrained as well as enhanced by devolution. Other reports, in this series, detail area based regeneration, indicators of poverty and social exclusion, employment and employability and housing and homelessness.
Older people's vision for long-term care
- Authors:
- BOWERS Helen, et al
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2009
- Pagination:
- 56p., bibliog.
- Place of publication:
- York
The research project explored the voice, choice and control of older people living with high support needs. The research involved a scoping study exploring the current role of long term care; a series of discussions with older people, their families and professionals; synthesis of key messages with a diverse advisory group; local feedback; and a national ‘sounding board’ event to identify the key messages to be shared. Those involved in the study emphasised the need for all sectors to work to ensure that older people's vision for their own future is widely owned and used to move from the current default model of residential care towards a range of more flexible options.
We've looked at care form both sides now: the effects of alternative evaluation strategies on study conclusions
- Authors:
- KANE Robert L., KANE Rosalie A.
- Journal article citation:
- Journal of Aging and Social Policy, 21(3), July 2009, pp.246-255.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
This study uses two studies about the role of managed-care programs in serving Medicaid long-term care clients in Florida to illustrate how different research designs can reach divergent conclusions. Two reports from different groups using essentially the same database to assess the impact of managed care on a group of older Medicaid clients served by a Nursing Home Diversion Program reached different conclusions. The report from Florida's Office of Program Policy Analysis and Government Accountability concluded that the Diversion program saved money, whereas the report from the Florida Policy Exchange Center on Aging at the University of South Florida reached basically the opposite conclusion. Both agreed that the capitation rate was too high. How the policy questions are framed and analyzed can affect the conclusions reached. A variety of factors can influence the apparent effects of programmatic interventions. Evaluations must take relevant confounding variables into account.
Do the determinants of health differ between people living in the community and in institutions?
- Authors:
- ASAKAWA Keiko, et al
- Journal article citation:
- Social Science and Medicine, 69(3), August 2009, pp.345-353.
- Publisher:
- Elsevier
The 1996/97 Canadian National Population Health Survey community and institutional surveys were utilised to identify factors associated with the selection of individuals to institutions. Whether the same determinants of health variables explain variations in health in those living in the community and those living in institutions were also examined. Logistic regression analysis was used to investigate factors associated with selection to institutions. Types of institutions included institutions for older people, psychiatric hospitals, and other rehabilitative institutions. Results showed that health status, age, chronic conditions, education, race, marital status, smoking and alcohol were associated with the probability of being in an institution. Multiple linear regression analyses (dependent variable: Health Utilities Index Mark 3 [HUI3] score) with individual characteristics, socio-economic status, and health risk factors were also estimated. Results showed that advanced age, higher number of chronic conditions, lower education, smoking and being an alcohol non-drinker were negatively and significantly associated with HUI3 scores for the community sample. Except for age, chronic conditions and being an alcohol non-drinker, none of these factors were significantly associated with HUI3 for the institutional sample. Moreover, the association between age and HUI3 was weaker for the institutional sample in comparison to the community sample. Implications are that, for those who are institutionalized, the usual determinants of health factors are less important. In conclusion, there appears to be important heterogeneity in determinants of health between persons living in the institution and community.
Individual decision making in the non-purchase of long-term care insurance
- Authors:
- CURRY Leslie A., et al
- Journal article citation:
- Gerontologist, 49(4), August 2009, pp.560-569.
- Publisher:
- Oxford University Press
Although prior research suggests that economic, behavioural, and psychosocial factors influence decisions not to purchase long-term care insurance, few studies have examined the interplay among these factors in depth and from the consumer's point of view. This US study intended to further illuminate these considerations, generate hypotheses about non-purchasing decisions, and inform the design of policies that are responsive to concerns and preferences of potential purchasers. The qualitative study used 32 in-depth interviews and 6 focus groups, following a grounded theory approach. Five themes characterize decisions not to purchase long-term care insurance: (a) the determination that a policy is "too costly" reflects highly individualized and complex trade-offs not solely economic in nature, (b) non-purchasers are sceptical about the viability and integrity of private insurance companies and seek an unbiased source of information, (c) family dynamics play an important role in insurance decisions, (d) contemplating personal risk for long-term care triggers psychological responses that have implications for decision making, and (e) non-purchasers feel inadequately informed and overwhelmed by the process of deciding whether to purchase long-term care insurance. States in the US are seeking to offset escalating Medicaid long-term care expenditures through a variety of policy mechanisms, including stimulating individual purchase of long-term care insurance. Findings suggest that economic incentives such as lowering premiums will be necessary but not sufficient to attract appropriate candidates. Attention to behavioural and psychosocial factors is essential to designing incentives that are responsive to concerns and preferences of potential purchasers.
Willingness to use formal long-term care services by Korean elders and their primary caregivers
- Authors:
- KIM Hyungsoo, CHOI Won-Young
- Journal article citation:
- Journal of Aging and Social Policy, 20(4), 2008, pp.474-492.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Logistic regression models were estimated using 2001 national survey data on 1,168 Korean adults aged 65 or older, and their primary caregivers. More than 70% of the older people were female, mostly with very low levels of formal education, and the majority lived with adult children or spouses. The attitudes of both older people and primary caregivers towards care responsibility were the dominant predictor of willingness to use formal long term care services. These attitudes need to be taken into account as policy makers attempt to normalise the use of formal care (home-based or institutional) and reduce the burden on informal carers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Community-based programs and policies: contributions to social policy development in health care and health care-related services
- Editors:
- PALLEY Howard A., (ed.)
- Publisher:
- Routledge
- Publication year:
- 2009
- Pagination:
- 162p.
- Place of publication:
- London
This collection is focused on the provision of community-based programs and activities in health and related long-term care services that have contributed, or may in the future contribute, to social policy development. Several of the articles in this collection deal with community-based health and long-term care program and policy initiatives that have been facilitated through federal programs such as Medicare, Medicaid and the Older Americans Act. The implementation of some of these community-based programs have significantly influenced social policy thinking regarding the beneficial effects of integrating medical and social aspects of health and long-term care services, as well as the health care team approach to the delivery of health and long-term care services. Another dimension addressed is the impact of interest groups, such as family caregivers, in advancing social policy that supports the efforts of community-based family care givers in providing services to patients in need. The underlying theme is how such local community programs have contributed in a variety of ways to the development of social policies at the community level that in many ways focus on the integration of health and related long-term care services and a health care team approach to the provision of such services.
Review of older people's engagement with government
- Author:
- ELBOURNE John
- Publisher:
- Great Britain. Department for Work and Pensions
- Publication year:
- 2008
- Pagination:
- 83p., bibliog.
- Place of publication:
- London
On 22 May 2008, the Minister for Pensions Reform, Mike O’Brien announced that John Elbourne had been asked to: “Examine the current arrangements for the engagement of older people and the ability of those arrangements to inform policy and actions of Government at all levels". John publishes this emerging finding on 9 October 2008. On 18 November 2008, John presented his final report to Government. To ensure that everyone with an interest in this important area has an opportunity to provide views on John’s findings and recommendations, Rosie Winterton, Minister of State for Pensions and the Ageing Society is inviting comments.
Island of the free
- Author:
- VALIOS Natalie
- Journal article citation:
- Community Care, 2.10.08, 2008, pp.30-31.
- Publisher:
- Reed Business Information
The Isle of Wight has introduced free personal care for over-80s who meet the eligibility criteria of critical or substantial need. This has improved the lives of many older people by making home care free for many over-80s so they aren't forced to go into residential homes. The author explains how the changes were made and the benefits that have resulted.
Free personal and nursing care, Scotland, 2006-07
- Author:
- SCOTLAND. Scottish Government National Statistics
- Publisher:
- Scotland. Scottish Government National Statistics
- Publication year:
- 2008
- Pagination:
- 24p.
- Place of publication:
- Edinburgh
This Statistics Release presents the latest figures for free personal care and free nursing care (FNC). Free personal and nursing care was introduced in Scotland on 1 July 2002. The report covers home care and care homes.