Research on the Establishment of a Long-Term Care System for the Elderly with Alzheimer’s Disease Under the Background of Long-Term Care Insurance: A Literature Review

With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.

Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

Hospice and Palliative Care Services in South Korea Supported by the National Health Insurance (NHI) Program

Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hospice and palliative care services has evolved in diverse ways but there is little research on reviewing the past history of development and whole picture of them so far. So, the aim of this study is to review the old hospice and palliative care system and also to introduce the current one supported by the National Health Insurance Program in South Korea. The palliative care or hospice services in South Korea have been available in diverse settings and provided by different organizations (i.e. catholic hospitals or charity organizations). Finally, it was set up in 2004 that the hospice team or official Palliative Care Units (PCUs) was established in hospitals, in order to meet the end-of-life care for the patients with terminal cancer under the Cancer Control Act. The current hospice and palliative care services such as pain management, bereavement services, and counselling can be reimbursed by National Health Insurance program since 2008. Nevertheless hospice and palliative care services are available to dying patients, yet the utilization rate of hospice and palliative care services or the length of stay in the palliative care unit (PCU) is still relatively short compared to other country systems. South Korea is undergoing several efforts to expand the services in PCU along with the development of quality indicators for PCU. Hospice and palliative care services are still new in the health care system and unfamiliar to the public so it requires raising awareness for medical professionals and the public as well as further research.

Impact of Dialysis Coverage on the Provision of Universal Health Insurance in the Republic of the Congo

Introduction: The launch of health insurance in the Republic of the Congo took place against a backdrop of extremely high costs for dialysis, which was not one of the services financed within this framework. The aim of this study is to assess the impact of including dialysis in the health insurance package in Congo. Methodology: This is a descriptive cross-sectional study with an evaluative aim, analyzing the impact of dialysis on the financing capacity of health insurance and health facilities to provide this type of care. Results: The results show that including dialysis in the universal health insurance package will require an additional financial effort of 6.20% of the current total financing capacity of the care basket. Most dialysis sessions are provided by the private health sector (87.5%), whose health facilities are unevenly distributed across the country, and concentrated in the country’s two major cities. This problem is the dual consequence of the very high cost of a dialysis session (average cost 140,234,375 FCFA or 229 US Dollars) and the number of patients under care, which will increase in the absence of effective and ongoing prevention efforts against chronic diseases in general and end-stage renal failure in particular. Conclusion: Dialysis is a high-impact public health intervention. The impact of its inclusion in the universal health insurance care package is difficult to bear financially. For dialysis to be covered by universal health insurance, additional funding and improved technical facilities are needed.

Building Long-Term Care Insurance System in China

The objective is to explore the foundation of the elderly long-term care insurance system in China, which is to face the problem resulted from aging of the population. Adopting the contrastive analysis to introduce briefly the long-term care insurance system in German, Japan and America for our learning. Therefore, China＇s long-term care insurance system could not totally indiscriminately imitate the mandatory long-term care insurance system in German and Japan, it also could not copy the business model of nursing insurance system in America. The conclusion is that long-term care insurance system in China should use the experience of developed countries based on the basic national conditions, doing some relative works, such as establishing policies and regulations, strengthening personnel training, and improving the market specification.

Study on the operation effect of long term care insurance system in Qingdao

Population aging has become a global social problem, the problem in our country has become the core of the aging problem. With the gradual aging of the elderly, loss of energy, loss of energy has become the norm for the elderly or sick elderly. According to the Ministry of Civil Affairs statistics, as of the end of 2014, the number of disabled elderly in China reached 35 million, about 90% of the disabled elderly need professional care services and professional treatment to ease the pain. In order to deal with the social problems brought about by the aging of the population, in July 1, 2012, Qingdao City, the first in the country to establish a long-term health care insurance system, has taken a key step to crack the problem of aging. In this paper, the situation of Qingdao long term care insurance system as the research object, taking Qingdao city as study sites, according to statistical data analysis of the implementation effect of long-term local health care policy, and through questionnaires and interviews in the form of local residents to participate in the investigation of awareness, and perception. At the same time, the results of the survey on long-term health care insurance system in Qingdao, the operation effect of the overall analysis.

Long term care insurance system of Germany

1990s, Germany is facing a serious problem of population aging, in 1995, of the population over the age of 60 in Germany, the proportion of the total population is as high as 21%, the proportion is expected to rise to 36% in 2030. The growing demand for long-term care services by the rapid aging of population is the basic background of the introduction of the long-term care insurance system in Germany.

Research on the institutional design of the long-term care insurance in Shanghai

Shanghai went into the ranks of the aging society in 1979, as the first area which entered into the aging society in China. Along with the arrival of the ageing, the nursing problems of the old man and disabled elderly become the important factors which affect social development. The establishment of the legal system, System integration to realize resource optimal allocation, Division of multilevel optimization services provide new pattern can make it happen.

Analysis of the necessity of Shanghai＇s long-term care insurance

The aging population of Shanghai is China one of the most serious city, is also one of the cities of the aging problem is prominent. As a result, the city＇s endowment pressure also with aging and aging aggravate gradually increased, especially the old man nursing problems become the main problem in society. Study abroad to establish a long term care insurance comprehensive factors, considering the feasibility of the long-term care insurance in Shanghai, alleviate the pressure of the pension, the construction of a harmonious society.

Performance of Rural Municipalities After the 2015 Reformation of Long-Term Care Insurance in Japan

Worldwide,welfare is trending from a welfare state model to social participation to ensure the sustainability of health care systems.Japan,where the aging rate will reach 40%by 2060,reformed public Long-Term Care Insurance(LTCI)on a large scale in 2015 and started the Comprehensive Service project(CS project),which emphasizes the prevention of long-term care through social participation in the community.Through this project,communities work to develop prevention efforts revolving around the community salon/caféand mutual support,including all daily tasks that previously were the purview of family members.Each municipality has an obligation to promote a CS project through new community development initiatives among community members.The purpose of this study is to investigate the CS projects performed by rural municipalities and to explore the important factors for their success.The authors used a case study methodology and constant comprehensive methodology for analyzing interview data to pull out the elements of successful initiatives.The study shows that the following factors influence success:recognition of demographic risk,recognition of the ineffectiveness of LTCI services,developing a passionate philosophy and strategy as a municipality,developing community members’initiative,and having many assets and full participation in the community.These factors imply that community development is a critical part of any successful CS project.

Community-Based Health Insurance： An Evolutionary Approach to Achieving Universal Coverage in Low-Income Countries

The WHO World Health Assembly, and the most recent WHO World Health Report, have called for all health systems to move toward universal coverage. However, low-income countries have made little progress in this respect. We use existing evidence to describe the evolution of community-based health insurance in low-income countries through the three stages of basic model, enhanced model, and nationwide model. We have concluded that community-based health insurance development is a potential strategy to meet the urgent need for health financing in low-income countries. With careful planning and implementation, it is possible to adopt such evolutionary approach to achieve universal coverage by extending tax-based financing/social insurance characteristics to community-based health insurance schemes.

Research on the development mode of long-term nursing insurance ——taking Qingdao as an example

With the gradual development of society, scientific and technological progress, aging gradually aggravated, has become a hot topic of society. People to old age, self-care ability than in the past, not only suffer from disease, life has become difficult, coupled with the large number of empty nest family, the cost of care is also very high, whether it is to receive home care or professional institutions of care have great difficulties. Therefore, the community should be a large number of people with long-term care needs of the appropriate economic compensation, in this context, long-term care insurance is born. As a leading city in Shandong Province, Qingdao has introduced long-term care insurance and achieved good results. This paper analyzes the practical problems faced by Qingdao, that is, the development background of Qingdao long-term nursing insurance model, obtains the deficiency of Qingdao long-term nursing insurance, and then puts forward the corresponding countermeasures, and then ponders how to choose the long-term nursing insurance model of our country＇s future development.

长期照护保险对农村家庭消费水平的影响——基于CHARLS数据的实证分析

基于预防性储蓄等理论,运用双重差分法,依据中国健康与养老追踪调查(CHARLS)2011—2018年四期面板数据,考量长期照护保险政策对农村家庭消费水平的影响效应。结果显示,长期照护保险使得农村家庭消费水平总体提高了5.2%,这种消费促进效应突出地体现在食品消费、日用品消费、通信消费中,对文化娱乐消费和衣着消费影响不明显。异质性分析显示,非独生子女、收入高以及过去一年内有住院经历的农村家庭受长期照护保险政策的影响程度更大。机制分析表明,预防性储蓄、居民健康和代际经济支持是长期照护保险影响农村家庭消费的重要途径。鉴于此,应通过扩大城乡试点范围、建立多元筹资渠道、构建服务供给体系等方式,推动长期照护保险实现城乡全覆盖。

我国养老服务产业优化发展策略研究

我国正处在人口老龄化进程加速发展的关键期,对养老服务产业提出了庞大需求。文章探索养老服务产业发展的优化策略,为政府决策提供现实依据。通过实地调研、访谈等方式调查国内养老服务产业的需求和供给现状,查找养老服务产业发展过程中的难点,结合对美国、澳大利亚、日本和德国等国家养老服务产业的文献分析,总结其成功的经验。基于上述分析研究,提出增加制度供给引导行业有序发展、鼓励参与主体公平竞争、建立多渠道筹资机制、探索长期护理保险制度、完善养老服务服务人才培养体系、建立资格准入制度、搭建人才发展平台等方面提出具体对策。

长期护理保险制度试点中的老年人权益保障

基于我国现行的长期护理保险政策和实践,梳理总结了长期护理保险试点阶段的基本情况、主要经验与基本制度框架;结合实地调研资料,分析试点过程中老年人的权益保障问题。结果显示,筹资机制的多元性不强,参保范围与保障对象的城乡覆盖、失能失智覆盖不足,服务需求评估的精准度还有待提高,服务过程中老年人合法权益易受损害且申诉难度较高。结合国内外长期护理保险制度的实践经验,从老年人权益保障的公平性等视角出发提出了相应对策建议:拓宽筹资渠道;逐步扩大制度覆盖面;加大对农村及特殊困难群体的资源倾斜力度;以老年人需求为导向提供长期护理服务;加强服务标准监管与人才队伍建设;完善长期护理保险的法律规制与投诉机制。

长期护理保险经办服务与监督管理的国内外实践与启示

长期护理保险试点启动至今已有8年,如何推动其由点及面、全面施行是值得探究的现实问题。本文通过分析长期护理保险经办服务与监督管理的国内实践现状发现,当前存在政策覆盖范围不足、监管体系不充分以及现有护理资源供给不足等问题。因此,借鉴国外实践经验,从建立第三方监管机制、制定科学评定标准、促进政府跨部门协作与信息共享、强化人员技能培养等方面提出政策建议,以期为建立适应我国国情的长期护理保险制度提供启示。

我国养老产业发展“拐点”研判——基于多案例研究的典型事实

随着人口老龄化进程加速,我国的养老需求结构正在从生存型向发展型转变,这将为养老产业的发展带来广阔的市场空间,但当前我国养老产业发展相对滞后,仍面临严重的发展困境。我国养老产业发展的“拐点”何时到来?为回答好这个问题,本文以案例研究和实证分析相结合的研究框架,首先,以法、德、日、美四国为例,系统梳理其养老产业发展历程,总结归纳出养老产业发展“拐点”出现的共性特征;其次,聚焦日本养老产业发展轨迹,重点关注其介护险实施前后养老产业相关重要指标变化;最后,选取九个养老产业相关指标,基于指数平滑、灰色模型等方法对中国养老产业未来情况进行预测,并与日本可比时期指标情况进行比较,判断中国养老产业“拐点”出现的可能时间。研究发现:养老产业发展“拐点”的出现具有四个共性特征,分别是三支柱养老金体系改革、长护险制度全面实施、多元化服务助推医养结合、代际转换背后的产业增量机会,而中国养老产业发展“拐点”可能出现的窗口期将在2026—2030年间。

失能老人长期照护体系的构建与公共健康治理创新

失能老人的长期照护不仅对医学提出了难题,更对当前的社会治理和公共政策形成了严峻挑战。需要从公共健康治理的视角重新审视,基于价值、结构、工具维度建构分析框架,识别公共健康治理的价值共识、协同共治结构和政策工具。以青岛和上海试点的长护险制度为例,探索其背后呈现的公共健康治理的逻辑可以发现,健康议题的价值回归驱动了公共健康治理创新,治理权向多元化主体的扩散形成了健康问题协同共治的基础,长护险制度及其所包含的多元化政策工具使用共同促进了健康服务的共同生产。

广州市长期护理保险试点现状、问题及对策分析

广州市自2017年试点运行长期护理保险以来,在参保人群范畴、筹资与待遇、失能认定与护理服务等级划分、护理服务项目、服务定点机构以及监督管理体系等方面进行了积极探索,取得了长护险制度逐步优化、服务主体产业化、社区居家模式逐步成熟、服务及管理水平提升等成效。广州市长期护理保险目前尚存在人口老龄化趋势与长护险定点机构区域发展失衡、部分定点机构服务监管质量欠佳、服务实践覆盖面有待提升等问题。结合国家保险制度政策及信息化发展,提出了优化提升长护险服务主体空间布局、扩大长护险服务保障项目范围、灵活长护险给付制度、监管制度闭环体系和智慧化运行体系等建议。