The social long-term care insurance model: comparing actor configurations across countries and time

Fischer, Johanna

doi:10.1017/ics.2022.9

Cited by 3 publications

(2 citation statements)

References 48 publications

(102 reference statements)

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“…nursing homes, hospitals, home care, households, and social providers) (5). To date, only six countries have adopted national social LTC insurance systems, namely the Netherlands, Israel, Germany, Luxembourg, South Korea, and Japan (6). Japan is the first Asian country, which has adopted a public universal LTC insurance in 2000, principally covering all citizens aged ≥40 years (7).…”

Section: Introductionmentioning

confidence: 99%

“…To calculate the descriptive differences in LTC utilisation across education and income groups, but not the CI, both indicators were divided into five categories. The category for education included lowest (<6), lower-middle (6–9), middle (9–12), higher-middle (12–15), and higher (16+). Despite different pre- and post-World War II educational systems, this categorisation roughly corresponded to the distinctions between elementary, secondary, high school, and university or higher.…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic inequity in access to care among older people in Japan

Okamoto

Yamada

Kobayashi

et al. 2023

Preprint

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Objectives To assess the socioeconomic inequity in access to medical and long-term care (LTC). Methods We used data from Wave 6 (2002) through Wave 10 (2021) of the National Survey of the Japanese Elderly to assess gradients by income and education in access to medical care and LTC among Japanese individuals aged 60 years and above. Specifically, we assessed self-reported unmet needs for medical care and LTC, and public LTC use, and estimated the concentration indices (CI) to measure the degree of inequality and inequity. We standardised public LTC use by need and non-need variables. We analysed data derived from up to 1,775 person-wave observations from 1,370 individuals. Results The pooled incidence across waves of forgone medical care, self-reported unmet support for activities of daily living (ADL) or instrumental ADL (IADL), and those not certified for LTC services even with ADL or IADL limitations were 4.6%, 15.5%, and 62.5%, respectively. Public LTC use demonstrated pro-higher education and pro-rich distribution, whereas the gaps decreased for need-predicted use. Based on the CI estimates, no explicit inequality was found for forgone medical care. However, we observed inequity in standardised LTC use across education, indicating pro-higher education inequality, particularly among women and those aged ≥80 years. Conclusions Improving the understanding of available resources and strengthening the functions of health centres and communities are required to detect the needs of citizens and facilitate their access to necessary care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequity in access to care among older people in Japan

Okamoto

Yamada

Kobayashi

et al. 2023

Preprint

View full text Add to dashboard Cite

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Choice of formal and informal care among community‐dwelling older people with or without dementia under a long‐term care insurance pilot program in China

Shi,

Chan,

Yang

2024

Australas J Ageing

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ObjectiveThis study examines the use of publicly funded formal and informal care among community‐dwelling long‐term care insurance (LTCI) beneficiaries in China and how dementia differentiates the choice of care.MethodsUsing administrative data from a LTCI pilot scheme in Guangzhou (n = 2043), we conducted a multinomial logistic regression to examine the association between dementia and the choice of family members (informal unpaid care), domestic helpers (informal paid care) and care workers (formal care), controlling for demographics, living environment and intensity of paid care hours.ResultsMost LTCI beneficiaries chose a family member (65%), followed by a domestic helper (21%) and a care worker (14%). After controlling for covariates, LTCI beneficiaries with dementia were more likely than their counterparts without dementia to choose care provided by a care worker (RRR: 1.73) or a living‐in helper (RRR: 1.43) than a family member.ConclusionsA preference for informal care was observed among LTCI beneficiaries in China. Those with dementia were more likely than those without dementia to use care provided by non‐family caregivers. The pilot scheme findings provide further insight into care recipients' preferences for service utilisation and how dementia impacts these preferences, which should be considered in future policy and service provision.

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New agendas and old legacies? Comparing international organisations’ proposals on health and long-term care systems in Latin America

Sternkopf,

de Carvalho,

Fischer

2024

Global Social Policy

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The way in which international actors formulate proposals for reforming or establishing public social policies not only varies between different organisations but is also dependent on the policy field in question. This article compares the positions of two international organisations (IOs), the Economic Commission for Latin America and the Caribbean (ECLAC) and the Pan American Health Organization (PAHO), on the two related social policy fields of health and long-term care in Latin America. We apply qualitative document analysis to reports and strategy articles published by ECLAC and PAHO between 2000 and 2015. The analysis finds that despite some similar proposals by both organisations, there are also clear differences between their positions depending on the policy areas. While both organisations see the need to establish healthcare and long-term care as a human right, they have different ideas on targeted and universal approaches. Moreover, with long-term care as a new and emerging policy field, there is still much more variation in how the IOs address the topic, while proposals on healthcare are shaped by previous debates at international and regional levels.

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The social long-term care insurance model: comparing actor configurations across countries and time

Cited by 3 publications

References 48 publications

Socioeconomic inequity in access to care among older people in Japan

Socioeconomic inequity in access to care among older people in Japan

Choice of formal and informal care among community‐dwelling older people with or without dementia under a long‐term care insurance pilot program in China

New agendas and old legacies? Comparing international organisations’ proposals on health and long-term care systems in Latin America

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