Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries

Bibliographic Data

ID21467410
AuthorsRuth Waitzberg (0000-0001-6358-5059, Ben-Gurion University of the Negev, corresponding author), Andrea E Schmidt (0000-0002-1408-321X, Gesundheit Österreich), Miriam Blümel (0000-0002-8452-4666, Technische Universität Berlin), Anne Penneau (Institut de Recherche et de Documentation en Économie de la Santé), Antonis Farmakas (University of Nicosia), Åsa Ljungvall (Public Health Agency of Sweden), Francesco Barbabella (0000-0002-1497-0011, Istituto Nazionale di Riposo e Cura per Anziani), Gonçalo Figueiredo Augusto (0000-0002-1383-1319, Instituto de Medicina Tropical), Gregory P Marchildon, Gregory Marchildon (0000-0003-4898-2392, University of Toronto), Ingrid Sperre Saunes (Norwegian Institute of Public Health), Dorja Vočanec (0000-0001-7570-5863, University of Zagreb), Iva Miloš (University of Zagreb), Joan Carles Contel (0000-0002-9195-6432, Generalitat de Catalunya), Liubovė Murauskienė (0000-0002-6625-8843, Vilnius University), Madelon Kroneman (0000-0003-0587-0585, Netherlands Institute for Health Services Research), Molly Tambor (0000-0001-7970-6919, Jagiellonian University), Marzena Tambor, Pavel Hroboň (0000-0001-9837-6695, Charles University), Raphael Wittenberg (0000-0003-3096-2721, London School of Economics and Political Science), Sara Allin (0000-0002-0579-8985, Norwegian Institute of Public Health), Zeynep Or (0000-0002-6860-3735, Institut de Recherche et de Documentation en Économie de la Santé)
Year2020
Volume124
Issue5
Pages491-500
Publication date2020-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy (JOURNAL)
Journal identifiersISSN: 0168-8510 • E-ISSN: 1872-6054
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.healthpol.2020.02.013
PMID32197994
OpenAlexW3007510540
LanguageEN
Citations received3
References cited20

INTRODUCTION: Long-term care (LTC) is organized in a fragmented manner. Payer agencies (PA) receive LTC funds from the agency collecting funds, and commission services. Yet, distributional equity (DE) across PAs, a precondition to geographical equity of access to LTC, has received limited attention. We conceptualize that LTC systems promote DE when they are designed to set eligibility criteria nationally (vs. locally); and to distribute funds among PAs based on needs-formula (vs. past-budgets or government decisions). OBJECTIVES: This cross-country study highlights to what extent different LTC systems are designed to promote DE across PAs, and the parameters used in allocation formulae. METHODS: Qualitative data were collected through a questionnaire filled by experts from 17 OECD countries. RESULTS: 11 out of 25 LTC systems analyzed, fully meet DE as we defined. 5 systems which give high autonomy to PAs have designs with low levels of DE; while nine systems partially promote DE. Allocation formulae vary in their complexity as some systems use simple demographic parameters while others apply socio-economic status, disability, and LTC cost variations. DISCUSSION AND CONCLUSIONS: A minority of LTC systems fully meet DE, which is only one of the criteria in allocation of LTC resources. Some systems prefer local priority-setting and governance over DE. Countries that value DE should harmonize the eligibility criteria at the national level and allocate funds according to needs across regions

Actuarial science · Autonomy · Business · Commission · Economics · Long-term care · Political science · Public economics · Geriatric Care and Nursing Homes · Intergenerational Family Dynamics and Caregiving · Interprofessional Education and Collaboration · Medicine · Finance