Back to Search
Start Over
Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries
- Source :
- Health Policy
- Publication Year :
- 2020
-
Abstract
- 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.
- Subjects :
- RT Nursing
Budgets
media_common.quotation_subject
Qualitative property
Commission
HV Social pathology. Social and public welfare. Criminology
03 medical and health sciences
Long-term care
0302 clinical medicine
Humans
National level
030212 general & internal medicine
ddc:610
Organisation for Economic Co-Operation and Development
media_common
Public economics
030503 health policy & services
Health Policy
Corporate governance
Equity (finance)
Oecd countries
Equity
Long-Term Care
Payer agencies
Allocation formulaa
Business
Funds allocation
EquityFunds allocation
Allocation formula
0305 other medical science
Autonomy
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Health Policy
- Accession number :
- edsair.doi.dedup.....dad94dcc54ab912855afcac6b2f283ff