Monday, July 15, 2024

Strategies for Sustainable Long-Term Care: Financial Protection and Coverage Initiatives for the Elderly

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A rapid scoping review was conducted to identify and evaluate recent initiatives aimed at improving long-term care (LTC) coverage, financial protection, and financial sustainability for individuals aged 60 and above. The review sourced data from four databases and four grey literature sources, focusing on reports published between 2017 and 2022. A supervised machine learning tool was used to rank titles and abstracts, with two independent reviewers screening the sources based on specific inclusion criteria.

The review included studies published between 2017 and 2022 in any language that captured recent long-term care initiatives for people aged 60 and older, involved evaluation, and directly addressed financing. The data extracted were analyzed using descriptive qualitative content analysis, categorizing the data according to a pre-specified framework designed to answer the review’s questions and capture the outcomes of interest.

Among the 24 reports analyzed, 22 were published in peer-reviewed journals, while two were grey literature sources. The studies comprised a variety of designs such as quasi-experimental study, policy analysis or comparison, qualitative description, comparative case study, cross-sectional study, systematic literature review, economic evaluation, and survey. Several variables were considered including the level of disability, income, rural/urban residence, employment, and citizenship.

Long-Term Care

Overcoming Challenges and Implementing Effective Long-Term Care Insurance Models

The studies also addressed financial protection aspects such as out-of-pocket expenditures, copayments, and the risk of poverty related to the cost of care. Furthermore, the reports brought to light challenges to financial sustainability, including a lack of service coordination and system integration, insufficient economic development, and inadequate funding models.

The review concluded that initiatives requiring mandatory long-term care insurance and providing commensurate funding could aid in aging in place. Efforts to expand population coverage were common across the initiatives, with the potential for wider economic benefits. The initiatives that enable older people to access needed services while avoiding poverty induced by out-of-pocket expenses can contribute to improved health and well-being. Preserving the health of older individuals longer could potentially alleviate downstream costs and contribute to financial sustainability.


Original Article DOI: 10.1136/bmjopen-2023-077309

Original title: Recent innovations in long-term care coverage and financing: a rapid scoping review

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