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To describe, analyze, and compare two long-term care (LTC) systems for elders in Germany and Israel.

Secondary analyses of data on LTC beneficiaries, structure of service provision and content analyses of policy documents in a comparative perspective based on the Esping-Andersen welfare state typologies.

Descriptive background of demographic attributes in the two countries; discussion of LTC development laws which in Israel focuses on “aging in place” concept, where in-kind services are geared only to community-dwelling frail elders while in Germany it’s for community and institutionalized elders. Analyses of various service types provided their use, resources invested, and benefits incurred for frail elders and their family caregivers.

The advantages and shortcomings of the two systems were analyzed with recommendations for future developments. Such comparisons across nations can inform social policy debates in Germany and Israel as to how to prepare for population aging. The originality of such comparison can shed light on issues for LTC service development in other countries.

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.

Leading health care institutions have recommended greater alignment among health care and social services organizations as a strategy to improve population health. Deepening our understanding of how interorganizational relationships among health care and social service organizations influence care for people with complex needs could improve the design of interventions aimed at aligning these organizations to achieve health goals. Accordingly, we used qualitative methods to (1) elucidate the functions performed by health care and social service organizations caring for older adults and (2) investigate corresponding relationship forms. In-depth interviews with 175 representatives of health care and social service organizations in 10 communities were analyzed. Three distinct interorganizational relationships functions emerged: First, interorganizational relationships gave organizations a deeper and more accurate understanding of how their work was interdependent with the work of other organizations in the community. This function was achieved through coalitions that loosely tied large numbers of organizations and allowed information to flow among them. Second, interorganizational relationships allowed organizations to take joint action toward a shared goal, a function achieved in the form of pairs or small groups of organizations working closely together. Third, interorganizational relationships fostered accountability, with one organization advocating for the needs of clients or patients with another organization. Our results suggest that initiatives to promote regional alignment among health care and social services organizations may benefit from flexible models that anticipate a narrowing of partners to achieve tangible outcomes. Initiatives also need to accommodate low-level conflict that routinely exists among organizations in these sectors.

Racial and ethnic minorities utilize less healthcare than their similarly situated white counterparts in the United States, resulting in speculation that these actions may stem in part from less desire for care. In order to adequately understand the role of care-seeking for racial and ethnic disparities in healthcare, we must fully and systematically consider the complex set of social factors that influence healthcare seeking and use.

Data for this study come from a 2005 national survey of community-dwelling Medicare beneficiaries (N = 2,138). We examine racial and ethnic variation in intentions to seek care, grounding our analyses in the behavioral model of healthcare utilization. Our analysis consists of a series of nested multivariate logistic regression models that follow the sequencing of the behavioral model while including additional social factors.

We find that Latino, Black, and Native American older adults express greater preferences for seeking healthcare compared to whites. Worrying about one’s health, having skepticism toward doctors in general, and living in a small city rather than a Metropolitan Area, but not health need, socioeconomic status, or healthcare system characteristics, explain some of the racial and ethnic variation in care-seeking preferences. Overall, we show that even after comprehensively accounting for factors known to influence disparities in utilization, elderly racial and ethnic minorities express greater desire to seek care than whites.

We suggest that future research examine social factors such as unmeasured wealth differences, cultural frameworks, and role identities in healthcare interactions in order to understand differences in care-seeking and, importantly, the relationship between care-seeking and disparities in utilization.

This study represents a systematic analysis of the ways individual, social, and structural context may account for racial and ethnic differences in seeking medical care. We build on healthcare seeking literature by including more comprehensive measures of social relationships, healthcare and system-level characteristics, and exploring a wide variety of health beliefs and expectations. Further, our study investigates care seeking among multiple understudied racial and ethnic groups. We find that racial and ethnic minorities are more likely to say they would seek healthcare than whites, suggesting that guidelines promoting the elicitation and understanding of patient preferences in the context of the clinical interaction is an important step toward reducing utilization disparities. These findings also underscore the notion that health policy should go further to address the broader social factors relating to care-seeking in the first place.

Purpose – Mobility of youth in multiple foster care placements contributes to diminished life chances and outcomes. Foster care youth mobility during care results in numerous school changes within one academic year which hinders educational achievement. This qualitative study examines a group of Latino alumni of foster care and their experiences related to housing and education.

Methodology – Interviews with 25 young Latino adults ranging in age from 18 to 22 examined foster care placement, transitions to independence, and experiences after foster care. Researchers used a semi-structured interview guide, and tape-recorded interviews transcribed and coded for emergent themes.

Findings – Results suggest that as youth experience school mobility, social capital aids in promoting positive educational experiences. This research emphasizes the importance of positive social capital for Latino foster care youth and their educational achievement, evidenced in both adult and peer social networks. Few studies have examined Latino foster care youth experiences, and currently there are no studies that address educational experiences of these youth.

The purpose of this chapter is to examine how leaders furthered the development of a social enterprise in response to paradoxes. Data on leadership practices were collected through interviews and observations in an Italian Healthcare network over the organization’s first two years. The data indicate that leaders addressed paradoxes in developing several critical resources by using both top-down influence and bottom-up participation. Leaders used top-down practices to further organizational development along a known path when they could leverage technical expertise or a vision to address a source of tension. Bottom-up practices, on the other hand, permitted the discovery of new paths that had not been previously identified. Leaders leveraged such responses where tensions appeared intractable. Implications for managers and organizational development and change practitioners are discussed.

The proposed chapter will focus on university partnerships for sustainable development, specifically in relation to the health and social care sector. As this is a burgeoning field of research and enterprise, this chapter would provide a valuable resource and much-needed exploration of how and with whom universities partner in terms of sustainability in health and social care.

The majority of universities have health sciences and social care departments delivering courses at undergraduate, postgraduate, and doctorate levels. As such, the chapter presents the range of opportunities for interdisciplinary learning and working, shares methods to foster social responsibility through partnerships between students, staff, clinicians, and service users, and acknowledges the prospect of lifelong learning that partnerships in sustainability can generate.

While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to this topic has grown dramatically. Reforms that promote high-quality care as well as responsibility for total cost of care have shifted focus among health care providers toward upstream determinants of health care outcomes. As a result, there has been a proliferation of activity focused on integrating and aligning social and medical care, many of which depend critically on cross-sector alliances. Despite considerable activity in this area, cross-sector alliances in health care remain largely undertheorized. Both literatures stand to gain from more attention to carefully knitting together the theoretical and management literature on alliances with the empirical, health policy and health services literature on cross-sector alliances in health care. In this chapter, we lay out what exists in the current scientific literature as well as a framework for considering much needed work in this area. We organize the literature and our commentary around the lifecycle of alliances: alliance formation, including factors prompting alliance formation, partner selection, and alliance goals; alliance maturity, including the work of these cross-sector alliances, governance, finance and contracts, staffing structure, and rewards; and critical crossroads, including alliance timelines, definitions of success, and dissolution. We also lay out critical areas for future inquiry, including better theorizing on cross-sector alliances, developing typologies of these cross-sector health care alliances, and the role of policy in cross-sector alliances.