1 / 10

Long Term Care: Pragmatic Reform Ideas from Europe

Long Term Care: Pragmatic Reform Ideas from Europe. Richard B Saltman Department of Health Policy and Management Rollins School of Public Health Emory University European Observatory on Health Systems and Policies Brussels www.observatory.dk. In Western Europe:.

evadne
Download Presentation

Long Term Care: Pragmatic Reform Ideas from Europe

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Long Term Care:Pragmatic Reform Ideas from Europe Richard B Saltman Department of Health Policy and Management Rollins School of Public Health Emory University European Observatory on Health Systems and Policies Brussels www.observatory.dk

  2. In Western Europe: Broad range of system-wide, social strategies - Funding - Delivery

  3. Funding Ideas I MACRO LEVEL : SHI Separate Social Health Insurance Fund for long term care: -national -universal -mandatory -50% employer/50% employee -in-kind services, and/or -cash payments to informal carers (Germany, Austria, Netherlands)

  4. Funding Ideas II: MICRO LEVEL: CLIENT CONTRACTING FOR HOME CARE: Contract-based bidding to provide services to each client • based on IADLs • pre-qualified bidders • client budgets • municipal monitoring/regulation (Netherlands)

  5. Delivery Ideas I MESO LEVEL: ELDERLY HEALTH CENTERS • Modeled on well-child centers (“pram-distance”) (center of town) • Basic medical support - Nurse staffing to take blood pressure; give medications • Several observation beds (2-3 hours) • Paid for by municipalities • All elderly welcomed (Netherlands) • Minimum if any charge

  6. Delivery Ideas II MESO LEVEL: SYSTEMATIC SUPPORT TO INFORMAL CARERS • Dedicated Municipal Budget • Telephone Advice • Respite care (if carer gets sick) • Drop off day centers • Training (e.g. moving a heavy patient, etc) • Pension Points towards retirement (resembles “dagmama”/ Swedish child care) (Netherlands/Sweden/Germany)

  7. Observation#1 Key Characteristics of European Long Term Care Strategies: • Social not individual • Systematic not piecemeal • Mandatory funding sources (taxes or SHI contributions) • Universal services (open to all)

  8. Observation #2: Contrast w/ current U.S. strategies for home care: • Mostly self-funded/ well-to-do • Home/ individual based • Private Insurer driven • Technology / IT oriented

  9. From Modern Physicians, April 2, 2007 “Aging Population Spurs Innovation” John Dannher, M.D. “connected personal health and fitness products and services” “home-based technologies”: - motion sensers - video cameras - telemonitoring - functional clothing with on- body sensors - personal wireless networks - radio frequency identification (to track movement)

  10. The Core Challenge: 1) Designing Systemic, Social, Culturally Appropriate Adaptations 2) Overcoming Public Sector Paralysis

More Related