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Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries
R. Waitzberg, AE. Schmidt, M. Blümel, A. Penneau, A. Farmakas, Å. Ljungvall, F. Barbabella, GF. Augusto, GP. Marchildon, IS. Saunes, D. Vočanec, I. Miloš, JC. Contel, L. Murauskiene, M. Kroneman, M. Tambor, P. Hroboň, R. Wittenberg, S. Allin, Z. Or
Jazyk angličtina Země Irsko
Typ dokumentu časopisecké články, přehledy
- MeSH
- dlouhodobá péče * MeSH
- lidé MeSH
- Organizace pro hospodářskou spolupráci a rozvoj * MeSH
- rozpočty MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
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.
Advance Healthcare Management Institute and Charles University Prague Czech Republic
Andrija Stampar School of Public Health School of Medicine University of Zagreb Zagreb Croatia
Chronic Care Program Department of Health Barcelona Spain
Department of Health Services Research Norwegian Institute of Public Health Norway
Global Health and Tropical Medicine 1349 008 Lisbon Portugal
Institut de recherche et documentation en économie de la santé France
Laboratoire d'Économie de Dauphine France
Nivel 3513 CR Utrecht the Netherlands
Swedish Agency for Health and Care Services Analysis Stockholm Sweden
Citace poskytuje Crossref.org
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- $a Waitzberg, Ruth $u The Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, JDC Hill, P.O.B. 3886, Jerusalem 91037, Israel; Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Health Care Management, Faculty of Economics & Management, Technical University Berlin, Germany. Electronic address: ruthw@jdc.org
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- $a Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries / $c R. Waitzberg, AE. Schmidt, M. Blümel, A. Penneau, A. Farmakas, Å. Ljungvall, F. Barbabella, GF. Augusto, GP. Marchildon, IS. Saunes, D. Vočanec, I. Miloš, JC. Contel, L. Murauskiene, M. Kroneman, M. Tambor, P. Hroboň, R. Wittenberg, S. Allin, Z. Or
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- $a 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.
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- $a Schmidt, Andrea E $u Austrian Public Health Institute, Department of Health Economics & Health System Analysis, 1010 Vienna, Austria. Electronic address: andrea.schmidt@goeg.at
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- $a Blümel, Miriam $u Department of Health Care Management, Faculty of Economics & Management, Technical University Berlin, Germany. Electronic address: miriam.bluemel@tu-berlin.de
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- $a Penneau, Anne $u Institut de recherche et documentation en économie de la santé (IRDES), France; Laboratoire d'Économie de Dauphine (LEDa), France. Electronic address: penneau@irdes.fr
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- $a Farmakas, Antonis $u University of Nicosia Cyprus, Cyprus. Electronic address: farmakas.a@unic.ac.cy
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- $a Ljungvall, Åsa $u Swedish Agency for Health and Care Services Analysis, Stockholm, Sweden. Electronic address: asa.ljungvall@vardanalys.se
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- $a Barbabella, Francesco $u Centre for Socio-Economic Research on Ageing, National Institute of Health and Science on Ageing (IRCCS INRCA), Ancona, Italy. Electronic address: f.barbabella@inrca.it
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- $a Augusto, Gonçalo Figueiredo $u Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical - Universidade NOVA de Lisboa (IHMT-UNL), 1349-008, Lisbon, Portugal. Electronic address: figueiredo.augusto@ihmt.unl.pt
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- $a Marchildon, Gregory P $u Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada. Electronic address: greg.marchildon@utoronto.ca
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- $a Saunes, Ingrid Sperre $u Department of Health Services Research, Norwegian Institute of Public Health, Norway. Electronic address: Ingrid.Saunes@fhi.no
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- $a Vočanec, Dorja $u Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia. Electronic address: dorja.vocanec@gmail.com
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- $a Miloš, Iva $u Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia. Electronic address: ivamilos990@gmail.com
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- $a Contel, Joan Carles $u Chronic Care Program, Department of Health, Barcelona, Spain. Electronic address: jccontel@gencat.cat
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- $a Murauskiene, Liubove $u Public Health Department, Institute of Health Sciences, Faculty of Medicine, Vilnius University, LT-03101, Vilnius, Lithuania. Electronic address: Liubove.murauskiene@mf.vu.lt
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- $a Kroneman, Madelon $u Nivel (Netherlands Institute of Health Services Research), 3513 CR Utrecht, the Netherlands. Electronic address: m.kroneman@gmail.com
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- $a Tambor, Marzena $u Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, 31-531 Krakow, Poland. Electronic address: marzena.tambor@uj.edu.pl
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- $a Hroboň, Pavel $u Advance Healthcare Management Institute and Charles University in Prague, Czech Republic. Electronic address: hrobon@advanceinstitute.cz
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- $a Wittenberg, Raphael $u Care Policy and Evaluation Centre, London School of Economics and Political Science, London WC2A 2AE, United Kingdom. Electronic address: r.wittenberg@lse.ac.uk
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- $a Allin, Sara $u Department of Health Services Research, Norwegian Institute of Public Health, Norway. Electronic address: Sara.allin@utoronto.ca
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- $a Or, Zeynep $u Institut de recherche et documentation en économie de la santé (IRDES), France; Laboratoire d'Économie de Dauphine (LEDa), France. Electronic address: or@irdes.fr
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