Dissertations / Theses on the topic 'Long term care'
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1
Holt, Jim. "Navigating Long-Term Care." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6474.
Abstract:
Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States. Transitions of care, among these various levels of care, are common: Nursing home to hospital transfer, one of the best-studied transitions, occurs in more than 25% of nursing home residents per year. This article follows one patient through several levels of care.
2
Hernández-Pizarro, Helena M. "Essays on long-term care." Doctoral thesis, Universitat Pompeu Fabra, 2017. http://hdl.handle.net/10803/456565.
Abstract:
This thesis analyses the effects of expanding public Long-Term Care (LTC) benefits
in Spain, using three different approaches. In the first chapter, I estimate
the impact of public LTC allowances on the mortality of the beneficiaries. My
results suggest that providing care prevents a deterioration in health, such that
death is postponed when the level of needs is low or moderate. In the second
chapter –with Garc´ıa-G´omez, L´opez-Casasnovas and Vidiella-Martin–, we assess
the equity of the access of public LTC. We show that the system is particularly
inequitable regarding the form of provision of benefits. This translates into a
pro-poor concentration of longer waiting time to access care. Finally, in the last
chapter –with L´opez-Casasnovas and Nicodemo–, we investigate the unintended
consequences of a non-linear scheme of benefits. We identify that around 3% of
the claimants are upgraded to the next level of benefits, increasing the cost for the
system. Instead, the proposed linear system of benefits could make the system
more egalitarian and minimise the unintended incentives.Aquesta tesi analitza els efectes de l’expansió de les prestacions públiques en dependència a l’estat espanyol, des de tres perspectives diferents. En el primer capítol, estimo l’impacte de les prestacions públiques en la mortalitat dels beneficiaris. Els resultats suggereixen que la provisió d’atenció prevé el deteriorament de la salut, fins al punt de posposar la mort quan el nivell de dependència és baix o moderat. En el segon capítol –amb García-Gómez, López-Casasnovas i Vidiella- Martin–, avaluem l’equitat en l’accés als diversos serveis públics per a l’atenció a la dependència. Mostrem que el sistema públic de dependència és especialment inequitatiu en la forma de provisió de beneficis. Això es tradueix en major concentració entre els més pobres del temps d’espera per accedir als recursos públics. Al darrer capítol –amb López-Casasnovas i Nicodemo–, investiguem les conseqüèencies inintencionades d’un sistema de beneficis no lineal. Identifiquem que entorn el 3% de la gent que sol.licita les prestacions són classificats en nivells de necessitat per sobre dels que els pertoca, fet que incrementa el cost del sistema. És per això, que proposem un sistema lineal de prestacions, que esdevingui més igualitari i minimitzi els incentius perversos.
3
Sunding, Brooke Abrams. "Gratitude in long term care." Thesis, Spalding University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3621800.
Abstract:
An exploratory study was conducted to examine the effectiveness of a group gratitude intervention with 29 permanent residents at a long term care/ skilled nursing facility in improving elder mood, behavior, and well- being over a 3 week time period. The sample included individuals diagnosed with dementia, other cognitive impairment, major depressive disorder, insomnia, and generalized anxiety disorder. The gratitude intervention consisted of asking elders to share what they are thankful for at the dinner table each day. Measures included the Elder Well Being Scale and The Dinner Rating Scale. On both measures, higher scores indicated better functioning. To test the hypothesis that post treatment elder well-being will be significantly higher than pretreatment elder well-being ratings, a one-way ANOVA was conducted. Post-hoc tests revealed a statistically significant increase in Elder Well Being Scale scores. An ANOVA of comparing Dinner Ratings demonstrated a nonsignificant increase over the 3 week experiment. Implications are discussed.
4
Yauk, Jessica Ann. "Planning for Long-Term Care." Miami University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=miami1605102319925788.
5
Coe, Norma B. "Long-term care and the elderly." Thesis, Massachusetts Institute of Technology, 2005. http://hdl.handle.net/1721.1/33837.
Abstract:
Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Economics, 2005."September 2005."
Includes bibliographical references.
Long-term care expenditures represent one of the largest uninsured financial risks facing the elderly. Medicaid provides incomplete insurance against these costs: unlimited nursing home benefits with a deductible equal to the savings and income above the means-testing limits. While private insurance is available, fewer than 10 percent of the elderly are currently covered. This thesis explores how the elderly prepare for future nursing home use and the interactions between the private and public insurance systems. Chapter one exploits the state-variation in Medicaid generosity to study the financial response of the elderly to perceived future nursing home needs. I find that the elderly shift their consumption and savings decisions in response to Medicaid. Single households have lower net worth through the median of the distribution due to Medicaid policy. On the other hand, I find that married households do not lower total net worth, but they change their relative holdings of protected and non-protected assets. Chapter two explores the crowd-out effect of the public Medicaid program on demand for private long-term care insurance coverage. We estimate the impact of Medicaid program rules on private long-term care insurance coverage for the elderly. We find small but statistically significant marginal crowd-out effects.
(cont.) Our estimates imply that even a $67,000 decrease in the asset disregard for couples would only increase private long-term care insurance ownership among the elderly by 1.9 percentage points. These findings underscore that marginal reforms to the existing Medicaid program are unlikely to be an effective way of increasing private long-term care insurance coverage among the elderly. Chapter three explores individuals' expectations for future nursing home use. I compare self-reported probabilities to the statistical probability computed with a state-of-the-art model used by the long-term care insurance industry. I find that respondents tend to overestimate unlikely outcomes and underestimate likely outcomes. On average, though, the expectations are very accurate. I find that expectations for nursing home use evolve with health conditions in similar ways as the statistical probability. While I find that expectations include private information, they do not account for all information available to the individual, especially the individual's demographic characteristics.
by Norma B. Coe.
Ph.D.
6
Sheffer, Nathan D. "Memory Care Units in Ohio Long-Term Care Facilities." Miami University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=miami149339984336246.
7
Sullivan, Jacqueline Patricia Clay Tubbs. "Pastoral care to younger adults in long-term care." Theological Research Exchange Network (TREN), 1997. http://www.tren.com.
8
McDougall, Jennifer. "Fostering family relationships in long-term care." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/62604.
Abstract:
Family relationships are a significant part of a person’s life. Unfortunately, moving a relative from a family home into a long-term care (LTC) home requires the readjustment of family relationships from a familiar to a foreign environment and puts these relationships and associated family identity at risk. With the shift in focus to person-centred care and its need for the maintenance of family connection, the fostering of family relationships in LTC homes becomes an important part of properly enacting this approach to care.
This critical ethnography explored the ways in which family relationships are fostered in LTC and identified the efforts made and barriers that exist in the broader organizational and social context of LTC that influence how these relationships are fostered. Data from a larger critical ethnography was collected through semi-structured interviews with and participant observation of 12 family members, seven staff members, and three residents from a LTC home in an urban city in British Columbia, Canada.
Family members came into the LTC home to spend time with their relative and maintain a connection with them, but a lack of opportunity to take part in activities that recognized the importance of these connections prevented family relationships from being fostered. Task-focused care overlooked the importance of relational care and further prevented family relationships from being maintained. Physical and cognitive decline also made it difficult for family members to engage and connect with their relative, resulting in a significant impact on the fostering of family relationships. Driving distances and a lack of opportunity to maintain connections with relatives outside of the LTC home added to the challenge of fostering family relationships. Family members want to maintain family identities and associated relationships but require support in doing so. The findings from this study have implications for nursing practice, administration, education, and research.Applied Science, Faculty of
Nursing, School of
Graduate
9
Fashant, Crystal Saric. "Environmental Performance in Long Term Care Facilities." Thesis, Metropolitan State University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10742619.
Abstract:
This research examines the physical operations of a health care sector called long term care facilities. Long term care refers to organizations that provide onsite nursing care for people with long-term illnesses, elderly people who need continuous medical supervision, or for those in long-term rehabilitation programs. Most specifically, this research looks at the performance of the physical buildings (i.e. facilities) and how this performance impacts the external environment. Using secondary data from the organization Practice Greenhealth, this study addresses the following two research questions.
1. What is the combined current state of environmental performance at the long term care facilities that have applied for a Practice Greenhealth award?
2. What are the proposed environmental key performance indicators for the long term care sector?
Based on this research, a model is suggested for future researchers interested in the environmental performance of long term care facilities. The model suggests six drivers for improving environmental performance in long term care; (1) maintain compliance with environmental regulations, (2) reduce costs, (3) meet expectations of parent organization, (4) increase market competitiveness, (5) engage stakeholders, and (6) improve patient outcomes. Four environmental improvement categories are then established; (1) waste, (2) energy, (3) water, and (4) engagement initiatives, along with each categories’ associated indicators. Finally, this study develops a concise environmental performance survey that could be used by any long term care facility looking to make improvements to its environmental performance over time.
10
Jarek, Holly Elaine. "Administrative changes in pediatric long-term care." Thesis, The University of Alabama at Birmingham, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10105905.
Abstract:
This research used a Delphi methodology to solicit challenges that significantly impact the operational success of pediatric long-term care facilities. Further, this study sought to understand the ability of pediatrics administrators to impact, affect, overcome, or resolve these challenges. Round 1 accomplished the desired goal of eliciting a substantial amount of new qualitative information regarding administrative challenges in pediatric long-term care, which previously had been extant in the literature. In Round 2, data were distilled into categories and unique exemplars which in turn were validated by participants. In Round 3, administrators ranked and rated categories and individual challenges in terms of significance and impact.
Findings revealed that the most important challenges for administrators are those of working with an inadequate model that is designed for a geriatric population, inadequate Medicaid funding, and the lack of clinical and administrative indicators in pediatric long-term care. The most important challenges that could be affected by the administrators are related to inadequate model, clinical practice, and the need for diversification. Administrators believe they can strongly impact the rules, regulations, and protocols that are currently geriatric focused, develop pediatric long-term care indicators and evidence-based research, and impact their financial security by diversification.
The Delphi research accomplishes the desired goal of eliciting a substantial amount of new information regarding administrative challenges in pediatric long- term care and contributes to the broader body of knowledge in health services administration. The significant research findings suggest the need for changes in the regulatory and financial models in pediatric long-term care and the need for enhanced clinical practice though evidence-based practice and outcomes.
11
Desai, Mitul S. "Modelling future demand for long-term care." Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/341514/.
Abstract:
This research was jointly funded by the Economic and Social Research Council (ESRC) and the Engineering and Physical Sciences Research Council (EPSRC). As such, its underpinning and innovative aim was to explore the use of Operational Research (OR) techniques, a research area traditionally associated with the EPSRC, to address key societal problems traditionally associated with the ESRC. The ageing population presents many significant challenges for social care services at both a national and local level, one of which is to meet the demand for long-term care. The population of people aged over 65 will continue to grow for some time as the ―baby boom‖ generation ages. The concern for policy planners is whether there will be enough resources in place to handle the expected strain on the system in the future. The research presented in this thesis addresses this key issue, and was carried out in collaboration with the Adult Services Department of Hampshire County Council (HCC). The overarching aim of this thesis was to develop computer models (using data local to Hampshire) which would be of practical use in estimating the future demand and planning the supply of long-term care in Hampshire. A cell-based model was built to forecast the demand for long-term care in Hampshire from people aged 65 and over for the period 2009 to 2026. An important part of this research was to understand the main drivers of future demand for long-term care and to predict the future number of people with a disability. Hampshire County Council has already tried to address these issues of demographic change through a modernisation programme. Part of this has been the establishment of a contact centre called Hantsdirect. A discrete-event simulation model of the contact centre was developed. The two models were combined to explore the short- and long-term performance of the contact centre in the light of demographic change. This hybrid model has enabled HCC to explore the short- and long-term performance of the contact centre. This study combines OR with Gerontology, Demography and Social Policy. This research is novel as it iteratively combines a compartmental population model with a discrete-event simulation model. From an OR perspective, the aim was not only to explore the use of modelling in social care (where, unlike healthcare, there has not hitherto been a lot of research), but also to investigate the potential for combining different modelling approaches in order to obtain additional value from the modelling. This novel approach in a social care setting is one of the main contributions of this thesis.
12
Hogan, Georgiana, Janice Lazear, Jean Croce Hemphill, Catherine Hebert, and Emily Wood. "Constipation in the Long-Term Care Resident." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/asrf/2020/presentations/4.
Abstract:
An evidence-based clinical practice guideline was developed to prevent and manage constipation in the long-term care (LTC) resident. Constipation is a prevalent condition in the LTC resident. Guidelines do not address this vulnerable population. Constipation may result in poor nutritional status, quality of life along with increased health care costs and hospitalizations. A literature review was completed and evidence was evaluated and included into the initial draft recommendations. The guideline was reviewed for content validity using a Delphi Committee of clinical experts in gastroenterology, geriatrics, and pharmacy. The updated guidelines were presented to an interdisciplinary team of long-term care residents. Participants were asked to review and complete a survey regarding clinical applicability of the guideline. Thirty-one interdisciplinary members participated in the education session and 30 surveys were received. Overall, the interdisciplinary team members agreed or strongly agreed the guideline was clinically applicable. Finally, the guideline was evaluated by a group of doctoral prepared practicing nurse practitioners using the AGREE II instrument. The scores were >80% in every domain, with an overall score of 91%, indicating the guideline is high in quality. Development of this guideline signifies an initial step in the management and prevention of constipation in the LTC resident.
13
D'Avello, Maria. "Intimacy Policies In Long-Term Care Facilities." Bowling Green State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1435763892.
14
Keise, Kay. "Preventing Falls in Long-Term Care Facilities." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7813.
Abstract:
Falls and related injuries have affected residents in long-term care facilities for many years. It has been well-established that patient fall prevention includes staff education and hourly rounding in addition to adequate risk assessment. These steps, taken together, have the potential to decrease a 52.7% fall rate on the long-term care pilot unit. The purpose of this quality improvement project was to: (a) educate staff on the process of properly performing hourly rounding and (b) and achieve a decreased incidence of falls from the current fall rate. Thus, the practice-focused question for the project addressed whether rounding hourly on patients in a long-term care facility would decrease the numbers of falls and related injuries. The conceptual framework used for this evidence-based project was the Institute for Healthcare Improvement's rapid cycle improvement. A sample size of 40 residents' fall rates were compared for a 6-week period before the intervention of hourly rounding to the fall rates after 6 weeks of full implementation of the rounding process. A Wilcoxon Signed Ranks test (z = -4.169, p < .001) showed that there was a statistically significant improvement in staff knowledge when mean pretest scores (75.9%) were compared to posttest scores (94.5%). Nursing staff were also evaluated on competencies, and 100% of the staff successfully completed the competency checklist on the first attempt. Post project fall rates revealed a decreased fall rate by 22% over a 6-week period post implementation. Nursing leadership should ensure that staff are continually educated on policies being implemented to ensure an effective outcome. Having hourly rounding as a permanent policy can decrease the patient's fall rate and improve patient safety, a positive social change.
15
Travis, Shirley S. "Self-care dependency among elders in long-term care settings." Diss., Virginia Polytechnic Institute and State University, 1985. http://hdl.handle.net/10919/49945.
Abstract:
General acceptance of a pattern of activities of daily living (ADL) dependency has led to the use of an additive method of determining self-care dependency and need for long-term care. This traditional method of determining ADL levels is convenient, and it is practical to the extent that individuals in a long-term care population do fit a scaled pattern of dependency. This research was based on 3611 cases from the Preadmission Screening Program of the Virginia Medical Assistance Program. Tabular and staged logistic regression analyses examined: 1) characteristics of this group of long-term care elders, 2) the extent of ADL divergence in various recommended care settings, 3) the relationship between rehabilitation status and ADL divergence, 4) other factors influencing divergence from the ADL dependency hierarchy.
The results of this study demonstrated that a large proportion of those screened did not match the original Index of ADL. Therefore, the justification for counting ADL dependency, based on an underlying hierarchy of ADL, was not upheld. Further research was indicated for improving eligibility and placement criteria that would reflect a fluid rather than a static system of long-term care. For example, rehabilitative trajectory could serve as an indicator of projected changes in assistance for self-care.Ph. D.
incomplete_metadata
16
Dawson, Walter. "The CLASS act and long-term care policy : the politics of long-term care financing reform in the United States." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:fa5269a1-8ce2-4105-b643-f9c2fffb23d8.
Abstract:
This thesis seeks to contribute to the knowledge base about social policy in the United States, using long-term care (LTC) financing policy reform as an illustrative example. Specifically, this thesis explores LTC financing reform efforts during three U.S. Presidential administrations: Bill Clinton (1993-2001), George W. Bush (2001-2009), and Barack Obama (2009-2010). Within this historical framework, the LTC provisions of the Health Security Act of 1993, the development of the Community Living Assistant Services and Supports or 'CLASS' Act during the Bush Administration, and the legislative success of the CLASS Act as a part of the Patient Protection and Affordable Care Act of 2010 provide comparable cases to compare the drivers of social policy. Drawing on the explanatory frameworks of the welfare state such as ideology, historical institutionalism, and an actor-centered approach to policy analysis, this thesis argues that successful path-departing legislation is difficult to achieve due, in part, to the presumed high costs of social programs and the complex institutional framework of the American political system. Policy outcomes result from the interaction between the complex processes and dynamics of the political system through which policy change (or the failure to change) actually occurs. The fact that the CLASS Act was politically successful, yet administratively inoperable as designed, reinforces the argument that social policy outcomes in the United States are reflective of a complex, enduring struggle of competing ideologies. This continual struggle, coupled with a heightened concern over cost control and fiscal austerity, helps to ensure that policies which are legislatively successful within the institutional architecture of the American political system are unlikely to produce major expansions of the welfare state. Social change is therefore highly difficult to achieve, even in the face of significant unmet social needs. Comprehensive reform of U.S. LTC financing arrangements will remain an elusive goal for the foreseeable future. Instead, incremental, highly pro-market solutions are likely to be the types of policies promoted in the years of ahead.
17
Yelland, Erin L. "Sex, Dementia, and Long-Term Care: Public Perspectives." UKnowledge, 2015. http://uknowledge.uky.edu/hes_etds/27.
Abstract:
The current mixed methods study utilized an ecological framework to examine public perspectives toward sexual behaviors among long-term care residents with dementia. Analyzing attitudes of the public is an integral component of understanding the entire ecological system that affects the development and overall well-being of a long-term care resident. Attitudes were examined using a multiple segment factorial vignette with a probability sample of 329 respondents from a southern state. Results indicate that attitudes were not statistically affected by sex or the elapsed time since diagnosis, and age, spousal disposition, and degree of intimacy predicted attitudes. A respondent’s education level also predicted attitudes across segments; those who attained higher levels of education were consistently more accepting of sexual behaviors, less likely to expect staff intervention in adulterous relationships, and were supportive of the healthy spouse beginning a new relationship. An ecological perspective provided a framework for guiding and informing future research on the influences of long-term care on sexual development and, in turn, for the development of relevant long-term care policy.
18
Sun, Pei. "Studies on public economics and long-term care." Thesis, University of Exeter, 2017. http://hdl.handle.net/10871/33020.
Abstract:
The Third Chapter: The aim of this research is to study individual choices of precau- tionary saving and long-term care spending when an individual faces the uncertainty of after-retirement health shocks. To do this, an improved two-period life-cycle model is employed. This paper also explores how individual choice affects economic development and capital accumulation in an overlapping generation economy. The study shows that the rise in the possibility of getting after-retirement health shocks will result to an increase in long-term care expenditure and the level of precautionary saving. The steady state will also increase in this case. The Fourth Chapter: The increasing and intensifying long-term care (LTC) demand brings great financial pressures for both governments and individuals. From the public perspective, the underlying economic question is how adequate real resources can be re- distributed to support long-term care need and how efficient the policies targeting is. As many LTC policies are accessed through means tests, individuals saving behaviour can be affected. This paper examines and compares the welfare effects that different means- tested policies have on individuals. We did this by embedding life-cycle models with after-retirement health shocks. Means-tested policies of long-term care, one with a top- up choice, and one without, were then simulated. The results show that the means test regime with a top-up option can bring a higher social welfare. Under this scheme, a higher means test threshold can decrease societys dependency on a social benefit system and increase social welfare. The Fifth Chapter: Attendance Allowance and Disability Living Allowance are the dis- ability cash benefits provided for people who are over 65 in the U.K. As the government plans to divert more public resource from these benefits to means-tested local care ser- vices, it is important to understand the effects and targeting of these cash benefits first. Using the survey data from English Longitudinal Study of Ageing, this study examines the relationship between the receipt of disability cash benefits and recipients’ character- istics among those who are over 65 in England. Although income is not a key factor to decide on the receipt of the benefits in the criteria, the results show that it still has a self- selection process where the benefits are given to those who are both most in need and on low incomes.
19
Hillary, Martin Ambrose. "Supporting Buddhist identity in long-term care situations." Thesis, Anglia Ruskin University, 2011. http://arro.anglia.ac.uk/211430/.
Abstract:
The Triratna/FWBO Buddhist movement has been associated with younger people and a lifestyle in which single sex residential communities and work projects (TBRLs) have been prominent. There is now a trend towards a wider range of lifestyles including fewer people living communally. Demographic changes include 50+ average age for ordained members and some people developing Long-Term Care (LTC) needs, with limited family and financial support. This raises questions as to the extent to which ‘Buddhist identity’ can be supported in LTC situations, with informal care, mainstream LTC services and possible care-based TBRLs all relevant.Data-gathering was initially on the basis of a general investigation of LTC issues in Triratna/FWBO using an eclectic, primarily qualitative design which had features of both a case study and a cross-sectional survey. 17 interviews included participants with current LTC needs, others asked to anticipate future care preferences, and people with relevant expertise. A questionnaire was formulated to explore attitudes to possible care-based TBRLs, with 107 participants and numerous additional comments. There was a strong consensus that Buddhist-based LTC services would, for example, provide better vegetarian diets and have an understanding of Buddhist names taken at ordination. These features were included in a conceptualisation of Buddhist identity which contrasted ‘Buddhist’ and ‘Non-Buddhist’ life, and noted ‘Dreams’ and ‘Nightmares’ as to LTC. Effective basic care was seen as essential to the general level of well-being needed for Buddhist practice, whilst a higher level of support might facilitate access to Buddhist ‘life goods’, and assist people in self-verifying themselves as committed Buddhists through ongoing practice. Informal support from fellow Buddhists was available in many contexts, but not at levels of intensity and duration characteristic of some family-based care, and it was seen as modulated by perceptions of burden, ‘busy-ness’ and other factors. There was a ‘legacy of suspicion’ of mainstream LTC, mainly focussed on residential care, with acknowledgement of some good/respectful carers and care services. TBRLs in LTC were generally welcomed, being seen as suitably altruistic work which might feature an atmosphere of ‘mutuality’ between staff and clients who were Buddhist or of Buddhist sympathy. Comparative material was used here from Methodist, Jewish and Lesbian/Gay/Bisexual/Transgender (LGBT) communities in LTC contexts, with the last of these conceptualised as comparable to the Western Buddhist community as a currently emerging identity in terms of later life services. Practicality and feasibility were discussed with reference to existing TBRLs, and experience of paid-for care input between Buddhists. The latter appeared supportive of Buddhist identity and readily linked to the personalisation agenda in social care. Buddhist-friendly services were seen as a possible context for generativity, and the concept of ‘a natural part of life’ was explored in terms of the emergence of LTC in the Triratna/FWBO movement, and of Buddhism as a gradually more familiar identity which might be encountered in the sphere of LTC.
20
Nie, Yajie. "Modelling long-term care for older people China." Thesis, University of Southampton, 2017. https://eprints.soton.ac.uk/408221/.
Abstract:
This report outlines an Operational Research (OR) model to plan long-term care (LTC) provision for older people in urban and rural China. Many countries in both the developing and the developed world have been experiencing a marked demographic shift towards an ageing population. An ageing society can present challenges, such as addressing the high demand for health and social care amongst older people, particularly in the latter part of the life course. Planning, delivering and financing such LTC provision for older people can be a challenge for local and national governments. This research is part of the EPSRC Care Life Cycle (CLC) research project at the University of Southampton, which aims to build and use a suite of simulation models to assist UK policy makers at the national and local levels in planning health and social care provision more effectively for future cohorts of older people, both in the UK and globally. The model outlined in this report is a contribution to this body of work. This research involves the development and use of a discrete event simulation (DES) model (which is named as ‘SIMCARE-CHINA’ model) to display the different pathways for using alternative LTC services among older people in China: informal, institutional, community-based, private, and voluntary services. The number of people who do not need care or who have unmet needs is also included in the model. This model is applied to different areas/levels – urban areas and rural areas –to consider the different LTC demand projections. The main dataset used to make the projection is composed of the Chinese Health and Retirement Longitudinal Study (CHARLS) and the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Data from other sources and previous studies are also used. SIMCARE-CHINA model can be used to test alternative scenarios and policy reforms and to evaluate their performance in terms of the LTC needs met amongst older people in urban and rural China, from the perspective of both the government and individuals. Thus, such modelling can offer researchers and policy makers an opportunity to understand the LTC system better and explore the outcomes and effects of different policies and reforms through simulation, with the aim of making recommendations for future improvements.
21
Yozwiak, Nicole A. "Thesis: Systematic Review on Long Term Care Models." Youngstown State University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1486112784386402.
22
Klimaviciute, Justina. "Essays in the Economics of Long-Term Care." Thesis, Toulouse 1, 2015. http://www.theses.fr/2015TOU10060.
Abstract:
Cette thèse est consacrée aux problèmes de la dépendance des personnes âgées qui devient de plus en plus un sujet « brûlant » dans les sociétés vieillissantes d'aujourd'hui. La thèse se compose de trois chapitres indépendants qui traitent de différentes questions relatives à la dépendance en soulignant l'interaction entre trois institutions : la famille, l'état et le marché. Le Chapitre 1 se concentre sur l'interaction entre la famille et le marché en étudiant l'aléa moral intrafamilial qui est l'une des explications potentielles de « l'énigme de l'assurance dépendance », à savoir l'étonnamment faible demande d'assurance dépendance privée. L'argument de l'aléa moral intrafamilial, proposé par Pauly (1990), est basé sur l'idée que l'assurance incite les enfants à privilégier l'aide formelle pour leurs parents (et donc à réduire leur aide informelle) car le coût de l'aide formelle est (au moins en partie) couvert par l'assureur et donc réduit l'héritage futur des parents moins que dans le cas sans assurance. Les parents qui apprécient l'aide de leurs enfants peuvent donc renoncer à acheter une assurance. Le chapitre propose et étudie formellement l'idée que l'ampleur de l'aléa moral intrafamilial et, par conséquent, du non-achat d'assurance dépendance peut être différent dans le cas où les indemnités d'assurance sont forfaitaires et dans le cas où elles sont proportionnelles aux dépenses liées à la dépendance. Les résultats obtenus non seulement confirment formellement que les indemnités forfaitaires aident à limiter l'aléa moral intrafamilial mais aussi démontrent que dans certains cas elles éliminent complètement ce phénomène tandis que l'effet des indemnités proportionnelles est au mieux ambigu. Par conséquent, le chapitre montre qu'il est plus probable qu'un parent décide d'acheter une assurance dépendance quand les indemnités sont forfaitaires que quand elles sont proportionnelles. A partir de ces résultats, le chapitre propose également quelques observations sur la politique publique. Le rôle de l'intervention publique est étudié plus profondément dans le Chapitre 2 qui analyse la politique optimale de la dépendance dans le contexte de l'aléa moral intrafamilial. En plus de s'attaquer aux inefficacités présentes dans ce contexte, le chapitre traite les questions de redistribution liées à l'hétérogénéité de la richesse. L'analyse révèle que l'aléa moral intrafamilial est une justification suffisante pour l'intervention publique axée sur l'assurance: si non nécessairement pour l'introduction de l'assurance publique obligatoire, du moins pour la taxation ou le subventionnement des primes d'assurance privée. Alors que les deux premiers chapitres étudient la famille sous l'angle de la relation parent-enfant, le Chapitre 3 invite à considérer un autre contexte important mais pour le moment beaucoup moins analysé, à savoir le contexte des époux âgés. Le chapitre propose un modèle théorique des problèmes liés à la dépendance rencontrés par un couple âgé et étudie l'intervention publique optimale dans ce contexte ainsi que fournit des observations intéressantes concernant l'assurance dépendance privée pour la femme et pour l'hommeLe résumé en anglais n'a pas été communiqué par l'auteur
23
Jzumg-Lu, Lin, and 林宗儒. "Long-term Care Services Act_For nonprofit organizations promoting long - term care Research." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/89445969488004066141.
Abstract:
碩士輔仁大學
非營利組織管理碩士學位學程在職專班
105
"Life, old age, illness and death" are unavoidable processes in life. The vast majority of people are being cared for. In addition to living well and living well, according to the survey, Taiwan people need about 7.3 years in their lives. . When their really old age, mobility, then how to face the next life? Children are usually busy and have their families, will not be no way to take care of me? In the face of aging, disability increase the rapid social, multitudinous mood in the community fermentation, and in the past highly concerned about the "Long-term Care Services Act", referred to as "long service law" is the best plan ahead answer. However, in the process of providing long-term services for non-profit organizations, the researchers focus on the problem and influence of the key provisions on the implementation process of the non-profit group, and hope to learn from the viewpoint of non-profit organization managers. The long service law is of great significance to promote the distribution and utilization of financial resources, logistics and human resources in the long service according to the long service law. The long service law is expected to solve the problems faced by nonprofit organizations in promoting the service process. And difficulties. For this study, qualitative research methods are used to conduct in-depth interviews with managers with practical experience, and to collate and analyze interview data. (Financial resources), logistics (service capacity) and the flow of people (service manpower), and so on to sort out and summarize some of the findings and issues worthy of Discussion Finally, this paper analyzes the current situation of non-profit organizations. The results show that non-profit organizations promote the long-term financial services (financial resources), due to the old and new government has led to the long service law lost the main source of income, long-term service law under the financial resources will produce crowding out effect. Logistics (service capacity) for the status quo, although the ability to solve short-term service, but the lack of long-term develop long-term education. In the end, there is a serious shortage of care workers, low pay, and low professional prestige, which will affect the willingness of young people to invest in the service of long-term service. Finally, the following suggestions are proposed for non-profit organizations to promote the long-term development of services: 1. gradually open long according to the insurance, so that long service more stable financial flows. 2. Open multi-level service personnel skills test, test homes additional caregivers national examination. 3. Technical and vocational schools to set up care, increase the care of young people. 4. To enhance the professionalism and sense of value in care. 5. Open senior service personnel to perform part of the body invasive work. 6. Reduce unnecessary non-profit written work. 7. Foreign workers are paid annually by the Employment Security Fund to subsidize their caretaker salaries.
24
Chen, Hung-Fei, and 陳虹妃. "On Taiwan’s Long- Term Care: Issues and SolutionsOn Taiwan’s Long- Term Care: Issues and SolutionsOn Taiwan’s Long- Term Care: Issues and SolutionsOn Taiwan's Long-Term Care: Issues and Solutions." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/59707818432278044984.
Abstract:
碩士長庚大學
企業管理研究所
94
This paper will first briefly describe current long-term care system and major changes in demographic, family, retirement, and lifestyle patterns. Comparing these changes with the long-term care system, we point out all the shortcomings and weaknesses of the system and introduce a new social security system deemed most suitable for accommodating the changes and integrating existing long-term care systems. The details of the operation of the proposed system are then described. Those issues most encountered by the existing long-term care system and questions with respect to the synergies of pensions, long-term care, and health care, are then answered under the system. Finally, I enlist the main advantages of the system and draw our conclusions.
25
Fann, Li-Yun, and 范立筠. "Long-term care preference and the intention of purchasing long-term care insurance." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/65776348099770312933.
Abstract:
碩士國立臺灣大學
衛生政策與管理研究所
97
The average life expectancy of Taiwanese citizens has increased due to improved living standard, educational level and medical technologies. The population of elders with chronic diseases has increased every year. Elders find it difficult to live independently due to their diseases, resulting in a greater need for long term care. This research surveyed 3002 subjects with the “2006 Taiwanese people’s intention for purchasing health insurance plan” (PHI questionnaire) to understand the causes of purchasing long term care insurance. The average age of the interviewees is 44.8, the gender distribution is even, mostly are married, about 40% are unemployed; their educational levels are mostly high school (41.5%) and university or above (33.3%); their average individual income is less than NT$ 50000 (86.6%), while the average household income less than NT$ 50000; 41.2% are ill, and 42.3% regard themselves as healthy; 7.4% were hospitalized in the last year, and 50.9% bought medicine from pharmacies for once during the past 6 months. 43.6% consider buying "long term care insurance” provided by the government or private corporations. Most of them (32.2%) choose to “stay at home, accepting the care from their children”; more subjects prefer long term care insurance for care provided by professional institutions than that for home care(OR =2.22, 95%CI =1.62~3.04), and more prefer long term care insurance for care provided professional personnel than that for family care(OR =3.98, 95%CI =2.76~5.75).
26
Chen, Chih-hung, and 陳志宏. "A Feasibility Study of Long-term Medical Care InsurancePay with Long-term Care Organization." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/kaq9x8.
Abstract:
碩士朝陽科技大學
保險金融管理系碩士班
93
Along with the old-age population in our country rise year by year, the change of the disease type, the birth rate descends and the proportion of the women go out the work increment. It has already become the social problem gradually for old-age and the traditional families have no idea to take care their life after retirement. Currently, the long-term caring system in Taiwan have not integrated yet, and can''t provide long-term care service for old people. In addition, national health insurance for the chronic disease only provides the basic guarantee, paying for the expenses of long-term care also insufficient. In light of this, this study aim at the long-term care service for the old people or chronic disease, by combining the long-term caring organization and business long-term care insurance over a long period of time, to provide the need with consecution of the long-term care and the medical treatment of the integrity service. Besides, we also expecting can let the medical treatment organization released more sickbeds to provide to the impatient sufferer through this, and solve the dilemma of the hospital a "one bed difficult beg" in Taiwan. This research with the Life-insurance policyholder of the central region in Taiwan, make use of the One-Way ANOVA to inquire into the caring cognition degree that the Life-insurance policyholder of the central region, and through the Logitistic Model to analyze the will that Life- insurance policyholder of the central region to purchase the" Long-term care insurance that provides with the long-term care organization ".
27
Lee, Pei-Hsuan, and 李佩璇. "Individualized Care Plan for Long-Term Care." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/97646705951398637418.
Abstract:
碩士國立臺北護理健康大學
長期照護研究所
102
It is important to provide individualized care plan for long-term care which is just lacking in our country, and with very hard positioning. It’s also the target of incoming long-term care insurance. The purpose of this study was to explore the existing value of specific individualized care plan, the care themes of long-term care needs, and the ideal format and content of individualized care plan. Nine professional who engaged in long-term care and two non-professional who took care of their families had been approached by "Individual in-depth interviews" of qualitative research, and the "content analysis" to deal with the information from conduction had been adopted, rather, also to make good utilization of advanced foreign experiences for saturation supplement. Based on the interview, we knew the specified individualized care plan can be capable of dealing care needs for the care receiver, in order to perform the proper care issues. Eight care themes can be organized on care needs quickly, i.e. "personal body care", "motor function care", "instrumental activities of daily living care," "psychological, cognitive, mental and behavioral problems care", "social participation", "health-related care," "family supportive" and "special status／consideration (of needs & care)". Six aspects of content as the format for ideal individualized care plan encompassed "information about life", "living needs", "service steps in detail", "service schedule", "appraisal" and "shift information in writing". We hope, in Taiwan, to develop the specific individualized care in accordance with the recommendations or proposing derived from the study, and applying in cases of long-term care actually.
28
Lee, Michelle Chia-Hui, and 李家慧. "Canadian Long-Term Care Research." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/mhmge7.
Abstract:
碩士國立中正大學
法律學研究所
103
Abstract 21st Century, We are facing human’s greatest threat. That is ageing; therefore, we must plan of action on ageing. In 1992, United Nation has Proclamation on Ageing hoping that governments, non-governmental organizations and private groups to ensure that the needs of the aged and their human resource potential are adequately addressed. Year 1999 is the International Year of Older Persons. From this, we can conclude that, everywhere around the earth is facing ageing. Now days, the elderly are getting older and older because of the booming technology and healthy living concepts. The world’s life expectancy average is never as high as now. Canada’s definition of Long-term care consists of medical and non-medical care provided to individuals who cannot live independently. The goal is to provide continuum of care to the needed other than Medical care. This way the caretakers are the main component of the long-term care not the physicians. The changes of long-term care in Canada goes side by side with the Health Care in Canada, due to that, we need to use Canada Health Care System as a background information or even as comparison information. The federal government and the provincial or territorial government separate their responsibilities into the federal government makes the law and the provincial and territorial government follows the law and operate it. Canadian Health Care system not only cares for the physical also for the mind and well-beings of the person. In the year 1984, Canada Health Act comes to active.
29
YANG, YA-CHU, and 楊雅筑. "Recognization of Long-Term Care System and Intention to Buy Commercial Long-Term Care Insurance." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/91504105586405998266.
Abstract:
碩士銘傳大學
風險管理與保險學系碩士在職專班
104
In recent years, rapidly aging population, longer life expectancy, low birth rate and other factors in Taiwan have changed family structure and reduced family care function, bringing issues, which come with aging society, such as elderly health, economic security and long-term care into more attention. Since 2007, the government has launched a policy called "Ten Years Long-term Care Program", and has passed "Long-term Care Services Act" in 2015. This Act is an important source of Taiwan's development of long-term care and will be implemented in two years. With the passing of Long-term Care Insurance Act, the government expected to share long-term caring risk through national self-help and mutual assistance, diversification of long-term care risks. In order to investigate people's apprehension on long-term care system and to assess people's purchase willing of long-term care insurance, my study was conducted with Internet questionnaire. This research reflects people's cognitive degree toward the government's implementation of long-term care policy and the public opinion will play a certain degree of influence effect. Therefore, my research will provide crucial references for government policy on the promotion of long-term care. Also for the insurance companies, the research can act as significant reference on selling long-term care insurance. The study uses statistical package for the social science SPSS (Statistical Package for the Social Science) to analyze the questionnaire. The result will be the following： 1.Basing on demographic variables, people’s perception toward long-term care system varies: We acquired that due to demographic variables such as occupation and numbers of the children, the perception of long-term care system are also different. 2.Basing on purchase willing variables, people’s perception toward long-term care system varies: We found that people with purchase willing are more concerned with long-term Care system. 3.Here are differences between demographic variables and purchase willing: We found that people who receive higher education have higher purchase willing; people with medium and high monthly income have higher purchase willing. 4.Here are differences between lifestyle variables and purchase willing: We found that people who expect elderly lives with higher disposable incomes have higher purchase willing; people who estimate higher charges on long-term caring have higher purchase willing.
30
LIU, TZU-WEI, and 劉子瑋. "The Development and Content of Taiwan Long-Term Care Policy-Discussion of the Long-Term Care Ten-year Plan and Long-Term Care Insurance Planning." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/20288915015272710634.
Abstract:
碩士玄奘大學
社會福利學系碩士班
99
The trend toward fewer children, the aging population structure, the rapid increase in the disabled population, the changing and often difficult role of family caregivers, the gradually decline in the role of family care, and the transformation of elderly living methods and family structures have caused a major disconnection between care supply and demand. This was the motivation for the development of Taiwan's long-term care policy. Nevertheless, the country must establish a truly effective long-term care supply, and should not just give economic assistance, or impose economic restrictions. Instead, the country must coordinate and integrate the various specialized areas connected with long-term care, and thereby construct an effective long-term care service network. As a consequence, the formulation of policy is a very important link in the development of a long-term care system. The implementation of the Long-Term Care Ten-year Plan, and the proposal of long-term care insurance, implies that this study happens to come at a key stage in the planning of long-term care policy. This study performs a comparative analysis of the two foregoing long-term care policies and conducts interviews legislators with policy decision-making powers in order to gain an understanding of and investigate the content and legislative angles and viewpoints on long-term care policies. This study ultimately seeks to probe the features of the country's Long-Term Care Ten-year Plan and long-term care insurance planning policies, which will underscore the meaning of this study. The following conclusions were drawn from the results of this study: First, the establishment of a "Long-term Care Insurance Act" and "Long-term Care Service Act" will provide the government with an important legal basis for the drafting of long-term care policies, and help to resolve the current discrepancies between the administrative and legal systems in the existing long-term care policy. It will also be an important step forward in the development of Taiwan's long-term care policy. Second, with regard to the government's provision of basic and necessary services, both policies should emphasize the minimum guaranteed payment as a service principle. The government should emphasize the concept of care service and responsibility in a family setting, and it will consequently be necessary to integrate the organizational system and service deliverables. Third, the financial planning model must shift from a single source of funding to multiple funding sources. Nevertheless, the fact that premiums are the main source of funding for the insurance system implies that the family will remain the main responsible party for funding care. Fourth, the long-term care insurance system does not have a concrete adjustment plan for improvement in the case of problems encountered by the Long-Term Care Ten-year Plan. In other words, there is no specific implementation plan with regard to the goals or directions of strategic adjustments. Legislators are quite aware that, in the development of the long-term care system, long-term care policy planning has significant deficiencies. Because of this, legislators have raised questions concerning many aspects. On the other hand, this does not indicate that they oppose the implementation of an insurance system, but merely that they regard policy content and relevant implementation measures as being highly important. This displays that long-term care policy has made the government's long-term care responsibilities a public issue, and the provision of support for long-term care by government and society is an essential step. Because of this, the primary focus should be placed on ensuring that policy content is reasonable and appropriate. In summary, Taiwan's long-term care policy formation process indeed has many structural problems that urgently require improvement. A comparative analysis of long-term care policies reveals the close relationship between government structure and welfare policies. Furthermore, there have in fact been many compromises and sticking points in the welfare development process, which has encompassed the stages of rejection, questioning, acceptance, and support. However, we believe that Taiwan's long-term care policy development trend is toward safeguarding a fair society.
31
Chi, Ying-Chen, and 紀櫻珍. "Effects of the Care Management Model on Long-term Care: Evaluation of the Long-term Care Service Center." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/04684548714332957186.
Abstract:
碩士臺北醫學大學
醫務管理學系
91
Abstract Title of Thesis: Effects of the Care Management Model on Long-term Care: Evaluation of the Long-term Care Service Center in the DaAn District of Taipei City Author: Chi, Ying-Chen Thesis advised by: Huang, Kuo-Cherh Dr.PH (Assistant Professor) In recent years, the Taiwanese government has emphasized the support for disabled elderly’s medical care and social welfare due to those people’s dramatically increasing demand for long- term care. The purpose of this research was to evaluate the care management model’s effectiveness on improving long-term care provided to disabled elders. The research employed a quasi-experimential design. A total number of 331 disabled elderly who were over 60 years of age, and living in Taipei City’s DaAn District participated in the study. Among the elderly, 166 received the care management model’s services (as the experimental group), while the other 165 did not receive such services (as the control group). The duration of the experiment lasted for the year 2002. The independent variable was the care management model. The control variables were sociodemographic characterities of the elderly (e.g., sex, age), health conditions (e.g., the degree of physical disability of the elderly), and the availability of care resources (e.g., number of children). The major findings of the study were: (1) Medical care utilization - Compared to the control group, the experimental group had less medical expenditures(OR=1.98, p<0.05). The probability of using less medical care was higher for samples with junior high school degree than those who were illiterate (OR=3.88, p<0.05). Respondents with 1-2 ADL disabilities, 3-4 ADL disabilities, or 5-6 ADL disabilities were more likely to use less medical care than those with only IADL disabilities (OR= 0.05, p<0.01; OR=0.09, p<0.05; OR=0.06, p<0.01, respectively). (2) Health-related quality of life - Respondents who were mainlanders, with severer cognitive dissonance, and with more children were less likely to suffer from deteriorating health, compared to their counterparts. (3) Satisfaction — Elders in the experimental group and their caregivers were more satisfied with the services they received, compared to those in the control group(OR= 0.05, p<0.001; OR=0.25, p<0.001, respectively). Respondents who suffered from severer cognitive dissonance were more likely dissatisfied with the services received, compared to their counterparts (OR= 4.30, p<0.05). Respondents who have more children were more satisfied with the medical services received, compared to their counterparts (OR= 0.17, p<0.01). Finally, compared to illiterate respondents, respondents who had college degree were more likely to feel dissatisfied with the services received (OR= 5.99, p<0.05). The research had confirmed that the care management model did help decrease the usage of medical services, and increase the satisfaction level of the elderly and their caregivers. It is suggested that the government should develop a sound care management model providing high-quality long-term care to the elderly, with the aim of decreasing the possibility of the elderly accepting institutional care. Key Words: care management model, effectiveness evaluation, long-term care.
32
CHEN, SZU-YING, and 陳思穎. "A Study Of Long-Term Care System And The Review Of Long-Term Care Insurance Draft." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/3f5n7a.
Abstract:
碩士國立中正大學
法律系研究所
104
Due to the progress of the times, medical advances, and aging society with fewer children, the fast growing elderly population has become a crucial issue for every country. On the one hand, some countries construe a social welfare policy to response to the aged society circumstance; on the other hand, some countries implement social insurance policy to establish a comprehensive long-term care system. Since 1980, Taiwan government also starts with serval policies to construct a corresponding environment for elder care. However, the aged in Taiwan still cannot receive an comprehensive long-term services on account of the legislative of long-term care system is not sturdy yet, and an urban-rural gap with resources distribution unequally. In order to prevent the above problems happen, the purpose of this study is to fully investigate the currency long-term care insurance draft in Taiwan compared to associated long-term care policy in other countries and aims to evaluate the feasibility of currency draft, to suggest the future policies, and to provide an introductory blueprint of long-term care insurance to whom are interested in this issue.
33
Lai, Hsin-Heng, and 賴信亨. "An investigation of the development of Long-term care Act and related long-term care industries." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/5p7f7h.
Abstract:
碩士中華醫事科技大學
醫學檢驗生物技術系碩士班
104
The purpose of this study is to investigate the relation between the Long-term Care Services Act and industries of long-term care services. With this study, we can understand the public awareness and need about the long-term care services. Worker of long-term care services can also take the information as references. To go a step further, the results can enhance the public awareness about the long-term care services in days to come. Data were conducted through questionnaire which consisted of four sections. The first section was intended to elicit basic demographic information on the respondents including age, marital status, education, occupation, and etc. In addition, the first section also examined the experiences of long-term care services. In section 2, the results of the questionnaire indicated that public awareness mainly focused on the topic about aging of the population and demographic trends. However, the issue about 10-year project of long-term care services is rarely known to the general public. Furthermore, the results of the third section of the questionnaire found that the public understanding about present Long-term Care Services Act and Long-term Care Insurance Draft is rather limited. The fourth section focuses on the perspective of the care recipients and caregivers. Moreover, the proportion of the items in the fourth sections was more equal due to the difference on the personal perspective. These findings reported that the general public is interested in results of questionnaire and information. We can understand other correlated rights and interests about long-term care services. Industries of long-term care services need to prepare a better design for the general public and persons who be nursed in the future. With this strategy, we can get the effective combination with families, persons who be nursed, and industries of long-term care services to reach the multi-wins.
34
Scales, Damon Cole. "Long-term survival after intensive care." 2007. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=479015&T=F.
35
Chiang, Chin-Yao, and 蔣欽堯. "The Ethics of Long-Term Care." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/j44g66.
Abstract:
碩士國立中央大學
哲學研究所碩士在職專班
97
Long-term care has become an emergent social problem in the 21st century. In ten years, there are going to be four million elder people in Taiwan and four hundred thousand of them will be in need of the service of long-term care. The main issue of long-term care is about whose responsibility of providing this service. Is it a problem to be solved in one’s family or should the whole society have the duty to take charge? Some people assign the primary responsibility of care to individuals and their families and insist that government should act only as the last payer for those unable to provide for themselves. Proponents of this view generally oppose giving aid to caregivers and denounce the aid to family would undesirably monetize family caring relationships. This thesis follows Norman Daniels’ theory of just health care to give an answer to this question about who should take the responsibility. Daniels points out three important aspects of just health care: the moral importance of health care, the relation between health and social justice and the scarce resource relocation. Daniels’ just health theory can well give us a good answer to the long term care because long term care is also an important branch of health care. Since Daniels develops the just health theory from John Rawls’ just theory, this thesis also make an attempt to explicate Rawls’ main concept about a just society. Long-term care can consume a great amount of social resource and the prices of some kinds of long-term care service could soar to the skies. The public health care system should not only improve public health but also have to protect people from the deprivation caused by illness. The responsibility of providing of long-term care service falls on both the individual family and the society as a whole. The aid from government to support long-term care is just like the aid given to public education or relief payment for those involuntarily out of work. This is not a waste of social resource but a practice of social justice. The social justice should guarantee the range of fair equality of opportunity. So each stage of life span has to be put into the same consideration. To ensure everyone can have access to the basic health care and long term care, it is both moral and reasonable to set the limits of providing care. Without the limits, long-term care could exhaust the scarce social resource and cause a greater disaster.
36
Lindo, Maria Leonor Sá Quental de Melo. "Improving processes in long-term care." Master's thesis, 2018. http://hdl.handle.net/10071/18313.
Abstract:
Process improvement applied in healthcare is a subject that is reaching a large
dimension over the years. Increasingly companies need to stay competitive and differentiate
themselves from each other. Lean as process improvement arises as a solution to improve
core processes and to gain competitiveness. In the healthcare area, arises as a cost reduction
solution in the health sector and allows the rationalization of resources and a better practice
of all processes inherent to the provision of the service, making the service an added value
for the customer.
This dissertation aims to identify how can process improvement add value to the
long-term care services, under the application of process improvement, namely Lean
Thinking tools. Furthermore, a theoretical framework is provided in order to support the
current investigation.
A methodology of dissertation with a case study is applied to the long-term care,
namely in medium-term and rehabilitation care, in Santa Casa da Misericórdia de Alhos
Vedros unit where direct observation, focus group and informal interview are performed
with stakeholders of the service.
Value stream mapping and flowchart are applied to the process of medium-term and
rehabilitation care. The customers of this service are identified as well as what is their value
perception of service. Value-stream mapping allows to identify sources of waste, and
possible improvement suggestions are presented.
The outcome of this research allows to improve the medium-term and rehabilitation
process and consequently the service delivery, making the process more efficient.A melhoria de processos aplicada na área da saúde é um tema que está a atingir grande dimensão no decorrer dos tempos. As empresas cada vez mais sentem a necessidade de se manterem competitivas no mercado, distinguindo-se umas das outras. Lean surge como uma solução de melhoria dos processos principais de uma empresa, o que permite um aumento de competitividade. No setor da saúde, surge como uma solução de redução de custos e permite a racionalização de recursos, bem como melhores práticas relativas aos processos de prestação do serviço, fazendo do mesmo um serviço valorizado para o cliente. Esta dissertação pretende identificar como é que a melhoria dos processos pode acrescentar valor aos serviços continuados de saúde, sob a aplicação de ferramentas Lean. Posteriormente, uma estrutura teórica é desenvolvida com o intuito de suportar a investigação. A metodologia de dissertação com caso de estudo é aplicada aos serviços continuados de saúde, nomeadamente em média-duração e reabilitação na unidade da Santa Casa da Misericórdia de Alhos Vedros, onde observação direta, focus de grupo e entrevistas informais foram aplicadas com os stakeholders do serviço. Value stream mapping e flowchart são aplicados no processo de media-duração e reabilitação. Os clientes do serviço são identificados bem como qual a sua perceção de valor do serviço. Value stream mapping permite identificar as fontes de desperdício e possíveis sugestões de melhoria são apresentadas. O resultado desta investigação permite melhorar os processos da média-duração e reabilitação e consequentemente a prestação do serviço, tornando o processo mais eficiente.
37
Tuan, Chi-Min, and 段繼明. "Systems for Long-Term Care Insurance." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/acuvsh.
Abstract:
碩士國立臺灣大學
財務金融組
106
Advances in medical technology and the improvement in living standards have increased the average life expectancy of Taiwanese people. However, declining birth rates have caused a rise in Taiwan’s elderly population, and Taiwan is gradually moving towards a hyper-aged society. Additionally, the number of disabled elderly people and those with chronic diseases also continues to increase, but changes in traditional family structures have led to a decline in elderly care resources. These factors all highlight the urgency of long-term care now and in the future, as well as the importance of preparing for long-term care needs in the future. Currently, the government and insurance companies are actively promoting long-term care insurance and establishing related systems. However, the penetration rate of long-term care insurance is only about 2%, indicating that stronger promotion and better design of long-term care systems is needed. In this study, we used quantitative analysis to investigate the Taiwanese public’s needs and willingness to purchase long-term care insurance, in hopes of providing improvement suggestions for insurance companies and the government.
38
Lauring, Catherine Ann. "Organizational strategies of staff nurses in long-term care." 1993. http://catalog.hathitrust.org/api/volumes/oclc/31306826.html.
Abstract:
Thesis (M.S.)--University of Wisconsin-Madison, 1993.Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 36-38).
39
HSIAO, HSIU-WEN, and 蕭琇文. "The Research on the demand for long-term care 2.0 and for long-term care private insurance, and on the future development of long-term care policy." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/y4fx3q.
Abstract:
碩士銘傳大學
財務金融學系碩士班
107
The risk of needing long-term care and senior care industry are much more important to people around the world. And the Ministry of Health and Welfare has adopted the Long-Term care Plan 2.0 on Jan. 2017. Therefore, this study conducts a survey for Taiwan eligible citizens through online and paper questionnaires. This study explores three topics, including realizing the public's demand for the Long-Term Plan 2.0, examining the main factors of the demand for commercial long-term risk insurance, and measuring the attitude toward the change of the government's long-term policy towards compulsory social insurance. These implications will serve as a reference for future government and insurance companies to promote long-term care insurance products. The empirical results are as follows: 1. Only 10.3% of the respondents who have experience in long-term needs have used government long-term subsidies. The higher the annual income, the lower the chance of using government long-term subsidies. There is a significant positive correlation between the needs of the long-term system and the number of family members is more than seven. 2. 67.9% of respondents indicated that they are willing to purchase disability support insurance. Among them, women, higher annual income, younger age, workers, LTC experience and people have a significant positive correlation with the willingness to pay for commercial long-term insurance. The willingness of people to purchase commercial long-term insurance will be significantly different in their willingness to pay because of the gender, age, annual income, current status of work, and long-term experience of the respondents. 3. 61.3% of the respondents supported the change of Taiwanese long-term policy into compulsory social long-term insurance. Among them, the annual income and current status of work will be significantly different from the public’s recognition of compulsory social long-term care insurance. Rich people and workers are more supportive of changing our long-term care policy to mandatory social long-term care insurance.
40
Ko, Tzu-Ting, and 柯姿婷. "Managerial Strategies for Long-Term Care Institutions : A Case of Small Long-Term Care Institutions in Taipei." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/5992g6.
Abstract:
碩士淡江大學
公共行政學系公共政策碩士在職專班
103
Due to the rapid change of social environment, the drop of birth rate, and the advancement of medical technology, those factors speed the society’s ageing process; hence, institutional care has become one of the necessary ways of caring the elder in the future. Therefore, the management strategy and ways of managing system of a long-term care institution will influence its service quality and its development. Our government has been promoting a ten-year long-term care project; besides, long-term care service law is also promulgated by the Legislative Yuan in 2015. The follow-up is to legislate the long-term care insurance law. Those mentioned above will make small long-term care institutions face the challenge of enterprise transformation. This study, taking the small long-term care institutions in Taipei City as the subjects, analyzes how the small long-term care institutions, under the impacts of the long-term care policy and the regulations related to senior citizens’ welfare, adopt their development strategy and business model. The questions discussed in this study, shown as below, are explored under the aspects---industrial environment analysis, present development, and future trends. 1. How do the small long-term care institutions, under the external pressure from market competence and government regulating the new laws and changing appraisal system, effectively use their internal resources to plan the management strategy? 2. What is the small long-term care institutions’ recognition towards the industrial environment and their own advantages and disadvantages? And how do they choose the business model and management strategy under the pressure of future changes of government’s policy. After reviewing the literatures about the management of long-term care institutions and the government''s policy and regulations, we depth-interviewed some managers who own small long-term care institutions in Taipei City. We realize the managing difficulties they are facing and their opinions about the future development of this industry. Analyzing the core issues in managing, the interviews and the research data, we proposed some suggestions for the small long-term care institutions and government as below: 1. Suggestions for the small long-term care institutions: (1) to develop as smaller-scale with more multiple functions. (2) to search for the partners of strategic alliances. (3) to reinforce the staff training and to improve the quality of care. (4) to strengthen the connections with the community and to grasp the needs for outward business development. (5) to keep the present superiority and build up the model of enterprise management. 2. Suggestions for the government policy: (1) to raise the subsidies for the lower-income families. (2) to modify the regulations of the limitation on smaller institutions. (3) to train professionals and well establish the career plans. (4) to simplify the appraisal system. (5) to guide the small institutions to develop multiple long-term care service.
41
JYE, TZENGRJ RONG, and 曾榮傑. "A Study on the Demands of Long-term Care Insurance for Elders in Long-term Care Institutions." Thesis, 2001. http://ndltd.ncl.edu.tw/handle/34821787415894305533.
Abstract:
碩士國防醫學院
公共衛生學研究所
89
INTRODUCTION：Due to the aging related problems and the change of structure of the society, there are increasing demands of long-term care. Usually the expense of the long-term care was payed by individual, and this payment has made a heavy burden for patient’s family. Although we have the Natioal Health Insurance Program in Taiwan, it still can’t satisfy the urgent needs for the long-term care of our people. We compare experiences of other advanced countries and plan a long-term care insurance to meet our demands. OBJECTIVES：The purpose of this research is to investigate demands and related factors about the long -term care insurance for the elderly who have received institutional care in the North Taiwan. METHODS：This is a cross-sectional study. A structural questionnaire was employed to collect data via personal interview. Data was collected from September to November, 2000. Subjects consisted of 465 persons whose age were over 65 years old, from 62 long-term care institutions (including 20 nursing homes and 42 elderly homes) in the North Taiwan. The researcher surveyed 120 valid cases from nursing homes, and 345 valid cases from elderly homes. RESULTS：The main findings of this study are as follows: 1.The results reveal 98.8% of the total cases never heard about long -term care insurance, 65.4% think that it is necessary to implement long -term care insurance, and 62.4% support government’s plan in establishing long—term care insurance, and majorly they have no opinions for amount, target insured population, policy and premium of the long—term care insurance. 2.In premium, the elderly think that NT$ 500-600 per month is reasonable, but most of them are willing to pay no more than NT$300. About 40﹪of the respondents would like to enroll the long-term care insurance and are willing to pay it, but if it needs an extra copayment, the number of willing to enroll will decrease to 30%. The average copayment of long-term care insurance is NT$878 per use. In short, there are around 60% of the respondents showing their demands for the long-term care insurance. 3.The differences of demand to long-term care insurance between nursing home and elderly home are the contents of the benefits and the types of insurance（conjuncted with Natioal Health Insurance Program or others）. 4.The main factors affecting the overall demand for long- term care insurance to the elders are: institutional types, geographical location, age, economic incomes, primary caregivers and chronic diseases. Based on the findings, the study has suggestions for the government: In order to satisfy the demands of long-term care for our people, the authorities should speed up the planning of long-term care insurance, and broaden the scopes of benefits of the Natioal Health Insurance Program in Taiwan.
42
Huang, Chia-Chi, and 黃家祺. "Perceived Quality of Long-term Care Service Providers and Users toward the Long-term Care Management Centers." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/92229135736571780898.
Abstract:
碩士高雄醫學大學
醫務管理學研究所
98
Purpose There is a few of case studies from either the prospective of service or prospective of service provider to review the caring quality in domestic, not to mention an appropriate measuring scale to evaluate the real situation. As a result, the purpose of this study hopes to develop service quality instrument from the prospective of service user to explore the Long-term Care Management Centers around Kaohsiung City & County with related factors to make a referral on the basis of Long-term Care Management Centers. Method This study was part of cross-sectional study, which made use of questionnaire to measure satisfaction among Long-term Care Management Centers, whereas the research subject aims to four main service items in Kaohsiung City & County, such as resident care, home care, rehabilitation, and breaking time care, to provide those needed users. Based on service provider satisfaction questionnaire issued by U.S.A federal health insurance and benefits plans (MCPSS), the first research tool of this study is ready to offer satisfaction questionnaire, which includes 7 dimensions, such as counseling, communication, professional skill, and decision-making power; as for second research tool, it covers 9 dimensions, containing information transmission, accessibility and convenience, service quality of center, as well as effectiveness of the service cases. The research tool is made up of self-style structured questionnaire and reviewed by two rounds of expert validity along with domestic and foreign literature collection. After recycled questionnaire, it is necessary to conduct test of reliability and factor analysis process, comparing the difference with the dimension of expert validity. The effective sampling includes 170 people of long-term care service provider as well as 331 people of long-term care service users; the questionnaire reliability of Cronbach''s α value for was 0.952 and 0.927, respectively. Result The long-term service provider only gave the overall satisfaction score for 3.46±0.55, communication for 3.66±0.54, professional skill for 3.39±0.57, decision-making power for 3.76±0.63, transferred procedure for 3.53±0.69, administrative instruction for 3.55±0.58, paid subsidy for 3.15±0.71; There are significantly positive correlations among different dimension of service provider satisfaction, especially the dimension of communication (r=0.682,p<0.001), indicating that the higher score, the higher of overall satisfaction. On the other hand, the affecting factor of satisfaction includes service type, case quantity, and seniority factor, while the service type is subject to the affecting factor of decision-making factor. Meanwhile, the satisfaction level of home rehabilitation higher than that of home service satisfaction(OR=7.83，95%CI=1.23~49.95).The long-term service provider only gave the overall satisfaction score for 4.24±0.47, signaling for 3.71±0.53, accessibility and convenience for 4.18 ± 0.45, service center quality for 4.03 ± 0.54, case effective for 3.57 ± 0.50, the effective of family burden for 3.80±0.44, personnel service quality for 3.88 ± 0.76, expertise for 4.01 ± 0.51, interaction and attitude for 4.32 ± 0.49; there are significantly positive correlations among different dimension of service provider satisfaction. The dimension between overall satisfaction and professional skill has a middle positive correlation (r=0.638,p<0.001), while the highest positive correlation is between professional skill and attitude (r=0.684,p<0.001). Regarding the satisfaction factor of service users, the more strong predictor of perceived health, the worse for overall satisfaction (OR = 0.29,95% CI = 0.13 ~ 0.64), other factors includes the ADL degree of disability, physical or mental disability levels, the number of children, type of service, the professional personnel background and so on. Recommendation and Suggestion The two main research tools in this study are consistent and reliable, can be offered as a reference tool for assessing satisfaction for health department. This study found out that service provider is not very satisfied with the quality of Long-term Care Management Centers, especially the aspect of subsidy application, followed by professional skill of personnel; meanwhile, the service user has a higher evaluation for service quality of Long-term Care Management Centers, especially the interaction attitude of personnel, accessibility and convenience, whereas it is unsatisfied with messaging capabilities and professional skill of personnel. Whether it is service provider or service user, they all agreed that the caring personnel are needed to strengthen his professional capacity. The centers should also provide personnel with good educational training to promote long-term related caring information, enhancing the quality of service management center.
43
Lin, Chia-wei, and 林嘉薇. "The Impact of Long-term Care Services Act in Long-term Care Facilities on Qualitative Research Finding." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/65073222353597487068.
Abstract:
碩士亞洲大學
健康產業管理學系長期照護組碩士在職專班
104
This research aims to investigate the passage of Long-Term Care Services Act, the controvercies within articles of the Act, and its influence on long-term care facilities. The Long-Term Care Services Act cleared the Legislature on May 15th, 2015 as a legal policy. On June 3rd, 2015 it was formally announced by the Executive Office of the President, and was planned to be implemented two years later, on June 3rd, 2017. The Act includes seven chapters and sixty-six articles. Its draft was raised in 2009 and authored in 2015. As this Act involves interests of various groups, the passage of the law was achieved in haste with many a debate and negotiation. The political process made huge influence on this Act. As a result, this research will focus on the passage of the Act and the combing of debates. The endeavors to analyze these phenomena and issues in this research are also to serve as a reference for future concerning policies. This research adopts qualitative analysis and the researcher interviews facilities individually via judgemental sampling. The interview content includes issues and controversies incurred on the passage of the law and its influences on long-term care facilities in the future. Based on the interviews, my conclusion and recommendations are as follow: 1. Funding will be the utmost influence on the practice of Long-Term Care Services Act. Sustanable provision of funding may substantially enforce the Act. 2. In the Act, establishment standard in facilities and professional personnel trainings are the prime sources of better quality. Yet affordability of facilities should also be taken into account so the Act can cover the most in need. 3. Long-Term Care Services Act focuses on the management of long-term care facilities, which does not correspond to the current situation.
44
Chen, Chiung-Han, and 陳炯翰. "The Study of Long-Term Care Industries Cope with Financial Reform Through the Long-Term Care Policy." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/5qr57w.
Abstract:
碩士義守大學
財務金融學系
106
Long-term care is more and more important, but the lowest utilization of it in this aging society of Taiwan. In 2011, it about seven 15-64-year-olds can support an elderly person not only the utilization of long-term care is 22.6%, foreign caregiver be chosen of the others, but also left 1.3 men can do this in prediction in 2060. The 10-year long-term care 2.0 plan is helpful or not for these person, fiscal deficit is rising still. In the light of this problem, we try to understand the real feeling of long term caregivers by questionnaire survey. The samples were gathered by convenience sampling for long-term care facility’s employee in September 2017, and the response rate is 81% that 75 questionnaires collected 61 questionnaires. The most respondents were married female at the age of 51, education of senior high school or vocational high school, 1-5 years of seniority, and the employee of long-term care facility and resident care attendant. The analysis of variance in five aspects of variety of financial resource and variety of policy. The results showed that age has significant effect on aspect of variety of financial resource, and none of the rest. The meaning is policy announced by inappropriate way, and people didn’t understand the full content and planning. According to the results, we reason out that long-term caregivers can’t understand the process and operation was caused by people didn’t care about the policy. And it makes the policy couldn’t feedback to the family members of patients.
45
Hsieh, Yu-Chung, and 謝宇忠. "The care need of institutional long-term care residents." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/05617246428417995930.
Abstract:
碩士嘉南藥理科技大學
醫療資訊管理研究所
98
This study was designed by cross-sectional method for exploring the characteristics of institutional long-term care residents. Our data was collected by the residents’ report of long term care institution. The research samples were selected from nursing homes and long-term care facilities at the Northern and Southern Taiwan. We used the statistic software of SPSS 12.0 version for the analysis of data describetion and analyze the difference with chi-square test. We went to understand the residents’ functional limitation of mental and physical, the status of residents receive professional care and their living assistance, and to compare the care need of residents among different facility that stay in Southern and Northern Taiwan. The results showed that there were 82.8% and 66.8% of residents with cognitive impairment in nursing homes and long-term care facilities, and nursing home residents with severe cognitive impairment were higher than the long-term care facilities. There were 28.0% residents need “non-professional nursing care” in nursing home that was less then the long-term care facilities(67.3%). In addition, the residents’ care need types were disparity between nursing home and the long-term care facilities, but the local difference was not significant. This study can provide the managers of institutions as a reference to set manpower and served the holistic care in facilities. This study were recommend that the main services of long-term care institution should be focus on the cognitive impairment and physical care needs. Furthermore, we were suggest to establish a long-term care information system for facilities management to avoid the early institutionalization.
46
Hu, Chun-Kai, and 胡竣凱. "A Study on the Financial System of Long-term Care: Lessons from Long-term Care Insurance in Japan." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/awm783.
Abstract:
碩士國立臺灣大學
法律學研究所
103
Recently, Taiwan has entered the aging society. Long-term care is becoming a major social policy issue. The patterns of assuming responsibility for the care of elderly by the families or individuals in the past, has been unable to respond to the increasingly heavy long-term care needs. The government had to take responsibility for the construction of long-term care system. However, the financial capacity of the government has its limits. It is hard for the government to provide sufficient long-term care services only by limited taxes. Thus, social insurance system has been used to release the burden on the government, but how to design or revise long-term care insurance system still needs further discussion. Japan implemented the long-term care insurance in 2000. As a social insurance, the insured has to pay a premium in order to afford the expenses of insurance. Also, the financial system has to keep self-sufficient. The social insurance contains the spirits of social solidarity and risk-sharing. Although the long-term care insurance in Japan has been through several reforms, the financial problems still exist. This thesis compares the backgrounds of development of long-term care insurance in Taiwan and Japan, and further evaluates the drafts of long-term care insurance in Taiwan. Taking Japan as an example, we can lead the long-term care insurance in Taiwan to the right direction.
47
WANG, Chin-Wei, and 王妗濰. "Development on Long-Term Care Services Industry in Taiwan- The Case Study of SHIANGBAO Long-Term Care Group." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/v7c9f3.
Abstract:
碩士中原大學
企業管理研究所
105
Aging society and long service has become an important issue across developments of countries. Such issues brought by population aging are very serious, including heavy state welfare, medical and caring burdens, reduction of labor population and the obstacles and difficulties of economic development. Therefore, all governments are stepping up their efforts to cope with such impact caused by population aging. Taiwan has implemented Long-term Care 2.0 as a trial at the end of 2016, and began its execution of long-term care service law on June 3, 2017; however, Taiwan long-term caregivers have their own operating pressures and difficulties, which also led to the exit of residential care and maintenance care institutions, as well as the structural changes in Taiwan. Such change has great impact on families with heavy care needs. The research target is SHINGBAO long-term care group, and the purpose of this study is to explore how Taiwan long-term care services industry continues to have sustainable development. First of all, this study understands the aging trends and categorization of long-term care service industry, and also analyzes the structure, market and barriers of long-term care service industry, while referring to long-term care service industry of other countries. Second, by understanding organizational structure and strategy of SHINGBAO long-term care group, factors that affect long-term care service industry are proposed. At last, this study conducts future strategy of Taiwan and China market for SHINGBAO long-term care group.
48
Chou, Wei-Shi, and 周韋詩. "Factors Affecting the Demand for Institutional Long Term Care and a Model for the Long Term Care System." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/71630019647601802647.
Abstract:
博士國立臺灣大學
國家發展研究所
94
First, this study investigates the determinants of the notional demand of institutional long term care of middle and old aged people. In particular, this study examines whether financial support is one of significant factors. From a national investigation in 1999, we choose those who are over 50 years old with the total number 3,182. This study uses logit model to analyze the effects of financial support、characteristics、 health status、caring human resources and attitude factors on the notional demand of long term care. When we employ financial support factors, we obtain the following significant factors: whether the interviewees have jobs、saving beforehand for the elderly life、 area、 whether receiving care when sick and the attitude. Without financial support factors, we obtain the following significant factors: area、marriage status and whether receiving care when sick. From investigation in 1999, area and dependence are stable significant factors no matter whether we employ financial support factors or not. By Likelihood Ratio test, we can know that the financial support factors significantly affect those 50 to 64 years old people. However, for those above aged 65, by likelihood ratio test of other variables, we find that caring human resources factors significantly increase the explanatory power of the regression. Therefore, our government should establish long term care policy aiming at different age groups. Next, we discuss the health care system and policy for the elderly in Japan and Taiwan, including long-term care insurance in Japan、the advantages and disadvantages of the long-term care system and future reform. Japan has become an aged society since 1970, when the rate of the 65+ population was up to 7%. In 1995, the aged population rate was already up to 14%, which means it only took Japan 25 years to double the rate. Japan has experienced quite rapid progress in population aging. Moreover, Japan has the longest life expectancy in the world now. Under the condition of rapid aging and diminishing family care resources, the construction of the long-term care system and policy is really important. After discussing Japan’s long term care system, we review Taiwan’s long term care system. By observing Japan’s system, we refer to some policy implications. Finally, according to the discussion about the health care system and policy for the elderly in Japan and Taiwan, we establish a health care system of Taipei elderly, including both mental and physical health, which ensures the rights and interests of the elderly. In addition, we hope Taipei can become the model city of the elderly, and other cities can learn much from Taipei. From the past, current and future elderly policy in Taipei, we can know both health and social sectors have the design and management rights. Therefor, we suggest establishing an “Elderly Bureau” to unify the implementation of the policy and the allotment of the resources. Besides, we divide Taipei into 4 sub-networks, and construct the ideal care system orderly, including income protection, medical care provision, housing arrangement, community care service and promotion of the living satisfaction. The most important is the establishment of “Medical-Nursing House”, providing the comprehensive care for the elderly. At last, a whole day and night elderly helping center network is established. However, the further detail planning needs to be researched in the future.
49
Wu, Hsiu-feng, and 吳秀鳳. "The Attitude and Influential Factors of Implementing Long-term Care Insurance of Proprietors of Long-term Care Facilities." Thesis, 2001. http://ndltd.ncl.edu.tw/handle/66474680561008168434.
Abstract:
碩士國防醫學院
公共衛生學研究所
89
There are about 1,865,000 aged people in Taiwan in 2000, accounting for 8.4﹪of the total population. This group of people requires the greatest amount of medical care and attention in daily life. Along with the declining functionality of the family and the reduction of the number of people looking after the elderly, we must face the pressure placed by the aged population on society. So far, there is no complete system of long-term care for the aged in Taiwan. However, the promotion of policies for long-term care has thus far dealt predominantly with financial planning. Is financial planning for long-term care the responsibility of the government or the responsibility of individuals? This research is chiefly aimed at exploring attitudes of proprietors of various institutions of long-term care toward operating insurance for long-term care (including views on operating insurance for long-term care, opinions regarding payment and the content of planning, as well as wishes and needs, etc.) and at getting acquainted with the features of these proprietors as well as the characteristics of various institutions of long-term care. Structural questionnaires were sent out to investigate 548 proprietors of institutions of long-term care in seven counties and municipalities in northern Taiwan. Of these, 418 (84.8％) questionnaires were returned, with 402 (81.7％) of these being effective. , The main findings of the research are as follows: 1.Proprietors of institutions of long-term care are mostly females, with an average age of 44, having on average a senior high school education. The chief motivation of their work is to meet social needs. Their experience in long-term care is about seven years on an average with about five- years of experience in running such institutions. 2.Institutions of long-term care are featured by daily-care institutions, institutions without juridical people, and private small institutions already registered in the city of Taipei(those unregistered are all daily-care institutions). Each institution has 11 to 29 beds with a balanced revenue and expenditure without government subsidy. There are typically enough employees. On average, each institution has about 43 beds. At present, approximately 29 beds are in use on average, giving a bed-utilization rate of 78％. Operating insurance for long-term care to help the aged and their families to pay for long-term care is the biggest hope of proprietors in regard to obtaining assistance in operation from the government. 3.Over 50% of proprietors have never heard about insurance for long-term care. Factors with following features are: proprietors in fairly advanced age, daily-care institutions, private institutions and subsidy of sanitary and medical institutions to be obtained. 4.85% of proprietors have voiced support, for long-term care insurance. Among them, proprietors with institutions in the city of Taipei with balanced revenue and expenditure and more beds and not receiving government subsidy have more favorable views toward and show greater support for the necessity of operating insurance for long-term care. 5.Most proprietors prefer payment in cash and the provision of materials when insurance for long-term care is implemented. Proprietors prefer that cash be paid to chief care takers while items of service should be mostly based on medical care. If disabled old people are looked after by their family members, most of the proprietors are willing to subsidize these care-takers. 6.According to proprietors, all people in Taiwan can enjoy insurance for long-term care. Insurance should be implemented through compulsory insurance participation attached to a health insurance system for all people. Collection of insurance fees should follow the pattern of the present health insurance system. People insured should pay a reasonable insurance-fee rate of 7.86％ and bear 15.52％ of the total medical fees. 7.75% of proprietors expressed willingness to take part in the special agreement of insurance for long-term care. The location of the institution and whether or not the institution is under a juridical person are important factors. 8.Nearly 70% of proprietors expressed a need for such insurance. The number of existing beds and the location of the institution are important factors. 9.According to proprietors, the most urgent factor affecting their willingness to consider such insurance is fund-raising. Main features include the city of Taipei, daily-care institutions, private institutions, dissatisfaction with the bed-utilization rate, failure to receive subsidy, and fierce competition in the market.
50
Jiahua, Tsai, and 蔡佳樺. "Recognization of Long-Term Institutional Care and Intention to Buy Long-Term Care Insurance by People in Taiwan." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/92606620789210575465.
Abstract:
碩士實踐大學
企業管理學系碩士班
100
For the recent years, the phenomenon of increasing elderly population combining with few generating is obvious. In a conventional understanding, only elderly people need long-term care. Taiwan government has already promoted the long-term care system in the past; however, just few information related to the long-term care system was received by general population. In the modern society, which has advanced technology of medical treatment, all disable people belonging to elderly population group is no longer existing. More medical care resource is needed by increasing disable people. From the statistics of disable population in the past decades, we could find the disable population percentage of younger ages increases by years, and so does the percentage of disable leaded by illness. In this circumstance, if we have an appropriate business insurance of long-term care, the less pressure and better quality of living will then be assured. In general, people in Taiwan do not own a good concept or understanding on business long-term care insurance. The resulting consequence is that higher expense, deeper pressure, and heavier burden on people needed care and their relatives. Currently, long-term care from government is conditionally granted, which will make the care not only inappropriate but also insufficient. So, in order to understand the actual situation and the related expense difference from the grant of government, an interview with private long-term care enterprise is also activated and included in the thesis. Eventually, business insurance will be a good supplement to the insufficiency of long-term care provided by government. Based on the social market demand, business long-term care insurance has been a product and has been promoted in recent years; however, the marketing share is still lower than estimation. By questionnaire survey, this thesis provides a study on the recognization of long-term institutional care and intention to buy long-term care insurance. The result of analysis shows that people generally have the concept of long-term institutional care; however, they just know a little on the detail of payment from long-term institutional care and less than 30% visited people have the intention to buy long-term care insurance. For the government side, this thesis recommends: reinforce the promotion of the importance of long-term care, and provide a complete scheme for long-term care allowance. For insurance company, this thesis provides the suggestions: reinforce the promotion of the importance of long-term care insurance, diversify the payment, and provide a scheme with well balance of encomy and insurance fee. Last but not the least, this thesis aims to help improve current long-term care system, raise the intention to buy long-care insurance, lower the society costs, and be the reference and direction for the following researchers.