The WHO Centre for Health Development (WHO Kobe Centre/WKC) has updated a series of country report summaries on pricing and purchasing long-term care (LTC) from its work with the Organisation for Economic Co-operation and Development (OECD).
Drawn from the book Pricing long-term care for older persons, the summaries aim to make these country case studies and experiences easily available to policymakers. They were edited by WKC’s Director, Dr Sarah Barber.
The summary for France examines the loose connection between pricing, costs and quality with regional inequalities across the country, and was prepared by Zeynep Or and Anne Penneau of the Institut de recherche et documentation en économie de la santé in Paris, France. Lessons for other settings include linking prices to the quality of services; improving information about the costs and quality of LTC services; regulating user prices; as well as enacting provisions for LTC care at home and recognizing informal family caregivers.
Germany has had difficulties in balancing among the priorities of universality, beneficiary choice, and quality for older persons. This brief was written by Ricarda Milstein, Michael Mueller and Luca Lorenzoni of the OECD in Paris, France. Some of the lessons for other settings include ensuring sustainability by finding the appropriate balance between increasing beneficiary numbers and public expenditures; contribution rates and copayments for beneficiaries; as well as balancing public and out-of-pocket expenses.
The brief for the Republic of Korea discusses overcoming coordination challenges between health and social services by Soonman Kwon, School of Public Health, Seoul National University, Republic of Korea. Lessons for other countries include the importance of coordination between health and LTC insurance systems; linking payments to quality and performance; and offering lower copayment for community-based care which promotes consumer choice and moving away from institutionalized LTC.
The summary for Spain reports on increasing beneficiaries and declining informal caregivers and was prepared by Manuel Flores of the Universitat Autònoma de Barcelona in Barcelona, Spain. Lessons include guaranteeing sustainability through stable revenues, as Spain’s population will be the oldest in the OECD by 2050; providing formal home care to shift from informal care, mostly provided by women; and setting prices and promoting quality.
Sweden provides and pays for universal and comprehensive care for older persons. This brief by Luca Lorenzoni of the OECD in Paris, France, explains the outcomes of Sweden’s major reforms of 1992 which give municipalities the main responsibilities for LTC for older persons. Some lessons for other settings include the need for sustainability; regulation; providing information for consumers for informed choices; and monitoring equity.
Click here for the full report, and here for more on this project.