Justice in Dementia Care Resource Allocation: How Should We Plan for Dementia Services?

Abstract

Dementia care resources in Taiwan have not been allocated taking into account patients’ needs and the distance between service users and providers. The objective of this study was to use two newly developed indicators; profit willing distance (PWD) and tolerance limited distance (TLD), to profile the service availability and accessibility of the 22 administrative areas in Taiwan and facilitate justice-based resource allocation by the central government. The study employed secondary data analysis by using a geographic information system (GIS) and geocoding to identify distances between service users and providers. The study samples were drawn from the databank of the National Disability Eligibility Determination System and grouped by the acuteness of registrants’ needs. Both the PWD and TLD were found in 15 of the administrative areas, and neither was found in three areas (Penghu, Kinmen, and Lienchiang County). Either the PWD or TLD (but not both) were found in four areas (only have PWD: Hsinchu and Chiayi City; only have TLD: Yunlin and Taitung County). How the priorities should be set for dementia service allocation based on these findings was also addressed. We conclude that the indicators of PWD and TLD can add value to the policy decision-making process, help set priorities, and facilitate efficient and fair resource allocation by defining specifics of the resources needed.

The role of geographic information system and global positioning system in dementia care and research: a scoping review

“…Some studies used mapping in preparing exposure data [67], arsenic concentrations [96], ozone levels [97], spatial distributions of air pollutants [98] and ranking countries in medical tourism [56]. Three studies mapped access to services [14,16,99], and only one used resource allocation related to the care of dementia patients [64]. Also, one study used mapping to visualize patients' mobility patterns [100].…”

“…The studies identify patients' needs and issues with resource allocations and develop health plans specific to the study area (64).…”

Development of Distance Cost Estimation Model for Health-Base on the Public official Information

“…Although the new indicators had developed by Yen & Lin in 2015 and 2019 which had greatly simplified, the study still uses the distance between the residential data of the case and the healthcare provider. From the above we can see that the important variable in estimating the distance cost is "where the patient lives" which address more specific be, the estimating will be more exact [3,18] .…”

“…Since its implementation in 1995, the national Health Insurance has not only reduced the financial barrier of people seeking medical care, but also improved the situation of poverty due to illness and solved the economic barriers to access to health care. However, many studies have found that even after the implementation of the national health insurance, the problem of inadequate or unequal medical resources is widespread in remote areas of Taiwan [1][2][3] . In order to properly allocate medical resources, our government has gradually improved the uneven distribution and quality of medical care through the regionalized health care concept since 1985, but it still cannot resolve the doubts of justice arising from insufficient and uneven medical care resources in the rural areas and the long distance between doctors.…”

“…The other accessible indicators are the distribution density of medical resources the distance and travel time for residents to seek medical care, and the specific individual medical care needs which need more geographic information, and private information as parametric to inferential. These are more important issue of justice and equity in resource allocation [3,[10][11].…”