The WHO Centre for Health Development (WHO Kobe Centre – WKC) conducts research on sustainable financing for health and long-term care which is important to ensure coverage, quality, financial protection and health outcomes for older adults.
While extending access and improving the quality of long-term care (LTC) services are sound public investments with economic and societal benefits, financing LTC is challenging. WKC has produced a series of briefs summarizing current evidence to guide policies and investments in low- and middle-income countries.
Brief 3 focuses on how countries finance LTC, with specific lessons for low- and middle-income settings. Where no formal LTC system exists in these countries, individuals, families, communities, and the health sector cover costs, which leads to inequitable access to needed services and reduced economic growth. In high-income settings, LTC spending is expected to rise from 1.7% (2019) of gross domestic product to 2.3% in 2040.
Sources of LTC financing include general taxation, insurance, out-of-pocket payments, and private contributions. General taxation provides a broad funding base and flexibility to cover benefits and ensures that those working in informal employment are covered.
In high-income settings where most adults are formally employed, mandatory insurance contributions are a stable source of LTC funding. However, in countries with a large informal workforce, this option is less feasible or equitable.
In collecting revenue to fund LTC, countries can opt to do this nationally or sub-nationally. However, decentralized funding for local purchasing or management may lead to inequities in availability and access to LTC services if central guidance and support are absent.
Read more about this work here.