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Long‐term care is getting more attention these days due to its impact on the growth of overall healthcare cost. With the implementation of the Medicare Part D prescription…
Long‐term care is getting more attention these days due to its impact on the growth of overall healthcare cost. With the implementation of the Medicare Part D prescription drug plan, the incentives and payment dynamics have changed the long‐term care market. This paper seeks to focus on the pharmaceutical market in the long‐term care space and to identify a few characteristics for the stakeholders' strategies.
The study used the IMS data sets, complemented by the information and statistics available in the literature to isolate the long‐term care market with regard to pharmaceutical products, its characteristics and dynamics.
The analysis showed that the market for pharmaceutical products in the long‐term‐care space is characterized by a couple of therapeutic classes, concentrated in a rather few geographical area in the USA. The traditional institutional based care is declining but the home health care use is increasing.
Access to the IMS data makes the findings of the study unique. Given the government sponsored prescription drug plan for the elderly is expanding, it will be of significant value to document the impact of the Part D plan on the overall healthcare cost in a dynamic long‐term care market.
Long-term care has increasingly been subject to mechanisms to manage care in order to control costs and meet institutional demands for cost containment and efficiency…
Long-term care has increasingly been subject to mechanisms to manage care in order to control costs and meet institutional demands for cost containment and efficiency. Fundamentally, managed care seeks to limit access to services that are deemed costly, intensive and/or long-term. However, long-term care by definition requires continuity of care across diverse service sectors. In order for managed long-term care to work, these sectors must be well integrated and able to share information about client needs. In this paper we examine the growth of managed care in the long-term care sector. We have collected data from long-term care agencies in adjoining counties (one urban, the other suburban) at three points in time (1997, 1999, and 2001) and are in a position to describe changes in the types of agencies providing long-term care, and the degree of managed care penetration in our sample. We also collected data on administrators’ evaluations of managed care, and their perceptions of the effect of managed care on services and service system integration. We conclude by discussing the future of long-term care.
This paper offers a personal perspective on the author's experience working with issues relating to the long-term management of nuclear contaminated sites, from the programmatic to the site-specific. Long-term care is and will be far more challenging than remediation activities; thus, the dynamics of long-term care require different approaches to problem solving. The need for nonlinear thinking will challenge management that has traditionally relied on linear approaches. Integrated risk management potentially offers some powerful and flexible tools for identifying and managing uncertainties. Managing uncertainties involves not only traditional budget, schedule, cost, and worker safety issues, but also other influences that are not easily quantifiable, including regulatory, cultural, social, political, legal, and “quality” issues. Understanding and incorporating changes in social context is critical to the planning and implementation processes of long-term care; the Department of Energy (DOE) must utilize processes that have consistency over time and that involve the public throughout the process. Management in the long term must reflect an understanding of how human systems function and how they couple with technological systems. DOE's relative success with its Uranium Mill Tailings Remedial Action Program exhibits some of these components. Many are now recognizing these components as key needs for any long-term care program for long-lived hazards.
This research examined how moving to a residential care home, a specific form of long‐term care facility, influences the quality of the relationship between seniors and…
This research examined how moving to a residential care home, a specific form of long‐term care facility, influences the quality of the relationship between seniors and their family members and how policies in these homes can facilitate relationships between residents and their family members. In this exploratory study, a total of five non‐spousal family members participated in a focus group discussion, and an additional 10 family members participated in face‐to‐face interviews. The two main themes that emerged identified that admission to a long‐term care facility had no influence on family relationships, or it had a positive influence on family relationships. The respondents identified how policies in the home can maintain or enhance family relationships. In particular, they appreciated very flexible policies that included few restrictions on when and where they could interact with their relatives and appreciated facilities providing private spaces to accommodate family interaction. The results of this study, and future research, will aid administrators in long‐term care facilities to develop policies that most support and enhance the experience of seniors and their ongoing relationship with their family members.
Although marketing does not play a large role in the Canadian health‐care system, acute care facilities have been conducting patient satisfaction surveys as a quality…
Although marketing does not play a large role in the Canadian health‐care system, acute care facilities have been conducting patient satisfaction surveys as a quality measurement tool for a number of years. More recently those in the long‐term care system have expressed an interest in this concept. This study set out to determine if long‐term care facilities in the Ministry of Health, Ontario Central West Region, conduct consumer satisfaction surveys. If they do, the study asked how the information is utilized and, if they do not, why not. This paper will highlight issues of service quality, health‐care quality and health‐care consumer satisfaction. This study is focused on long‐term care; however, the majority of the available research and information pertains to the acute care system. Although the principles of quality measurement and consumer satisfaction are the same for acute and long‐term care, our findings will identify the unique ways in which these principles apply to the long‐term care system.
This chapter will review the evaluations of the newly developed elderly care system in Japan, Long Term Care Insurance, and its social implications with the focus on…
This chapter will review the evaluations of the newly developed elderly care system in Japan, Long Term Care Insurance, and its social implications with the focus on demographic change.
By reviewing literature, this chapter will examine how demographic and social change over the years has impacted the features of caregivers. Then, how this policy change has demedicalized the aging process will be described. Finally, this chapter will evaluate whether this insurance has shifted the responsibility for elderly care from the family to society as the governmental slogan advertised.
The new insurance has offered more options in different services and established a new norm of self-reliance and determination for one’s own aging however it is doubtful if this new insurance has shifted the responsibility from family to society.
Applying the implications of policy reforms for elderly care in Japan to the United States, one can assume the traditional U.S. norms and values can facilitate effective utilization of the elderly care system. However, since each nation faces different problems with its specific condition, continuous studies and observations on the relationship between elderly care, immigration issues, and demographic changes will be necessary in order to offer more specific suggestions for each aging nation.
Originality/value of chapter
As Japan’s new insurance scheme for the elderly has been studied by many aging nations, recommendations for more comprehensive plans are suggested including building a community-based support system into the Long Term Care Insurance scheme to prevent social isolation and respond to emergency situations for the elderly.
Within the existing health care system, a significant percentage of Americans over the age of 65 will have need of extended health care. Yet the extended care industry has…
Within the existing health care system, a significant percentage of Americans over the age of 65 will have need of extended health care. Yet the extended care industry has little information as to how consumers will make a choice among placement options. The results of this study describe both the need recognition and pre‐selection search stages of the decision process and the impact of need recognition on subsequent search activity. The information obtained from an influential person as the problem is being defined appears to have a complex relationship with pre‐selection search, with initial information leading to less search but additional information increasing search activity. Contrary to previous studies, pre‐selection search was found to be fairly extensive, increasing with time availability.
Nurses and other professional caregivers are increasingly recognising the issue of moral distress and the deleterious effect it may have on professional work life, staff…
Nurses and other professional caregivers are increasingly recognising the issue of moral distress and the deleterious effect it may have on professional work life, staff recruitment and staff retention. Although the nursing literature has begun to address the issue of moral distress and how to respond to it, much of this literature has typically focused on high acuity areas, such as intensive care nursing. However, with an ageing population and increasing demand for resources and services to meet the needs of older people, it is likely that nurses in long‐term care are going to be increasingly affected by moral distress in their work. This paper briefly reviews the literature pertaining to the concept of moral distress, explores the causes and effects of moral distress within the nursing profession and argues that many nurses and other healthcare professionals working with older persons may need to become increasingly proactive to safeguard against the possibility of moral distress.
For frail older persons, gaining access to care is primarily in the context of long-term care institutions. Based on hypotheses derived from the theory of the total…
For frail older persons, gaining access to care is primarily in the context of long-term care institutions. Based on hypotheses derived from the theory of the total institution (Goffman, 1961) and anticipatory socialization theory (Merton & Kitt, 1950), linkages of intra-institutional and extra-institutional social ties with quality of life outcomes were assessed based on 168 residents’ self-reports of their life and problems experienced in long-term care (Kahana, Kahana, & Young, 1987). Findings reveal that lack of anticipatory socialization was a significant predictor of subsequent wellbeing, whereas the extent of social ties to the outside world did not predict subsequent wellbeing.