Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries

dc.contributor.authorWaitzberg, Ruth
dc.contributor.authorSchmidt, Andrea E.
dc.contributor.authorBlümel, Miriam
dc.contributor.authorPenneau, Anne
dc.contributor.authorFarmakas, Antonis
dc.contributor.authorLjungvall, Åsa
dc.contributor.authorBarbabella, Francesco
dc.contributor.authorAugusto, Gonçalo Figueiredo
dc.contributor.authorMarchildon, Gregory P.
dc.contributor.authorSaunes, Ingrid Sperre
dc.contributor.authorVočanec, Dorja
dc.contributor.authorMiloš, Iva
dc.contributor.authorContel, Joan Carles
dc.contributor.authorMurauskiene, Liubove
dc.contributor.authorKroneman, Madelon
dc.contributor.authorTambor, Marzena
dc.contributor.authorHroboň, Pavel
dc.contributor.authorWittenberg, Raphael
dc.contributor.authorAllin, Sara
dc.contributor.authorOr, Zeynep
dc.date.accessioned2022-03-15T15:40:27Z
dc.date.available2022-03-15T15:40:27Z
dc.date.issued2020-02-29
dc.description.abstractIntroduction: 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.en
dc.identifier.eissn1872-6054
dc.identifier.issn0168-8510
dc.identifier.urihttps://depositonce.tu-berlin.de/handle/11303/16562
dc.identifier.urihttp://dx.doi.org/10.14279/depositonce-15339
dc.language.isoenen
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subject.ddc610 Medizin und Gesundheitde
dc.subject.otherlong-term careen
dc.subject.otherequityen
dc.subject.otherfunds allocationen
dc.subject.otherpayer agenciesen
dc.subject.otherallocation formulaen
dc.titleMapping variability in allocation of Long-Term Care funds across payer agencies in OECD countriesen
dc.typeArticleen
dc.type.versionpublishedVersionen
dcterms.bibliographicCitation.doi10.1016/j.healthpol.2020.02.013en
dcterms.bibliographicCitation.journaltitleHealth Policyen
dcterms.bibliographicCitation.originalpublishernameElsevieren
dcterms.bibliographicCitation.originalpublisherplaceAmsterdamen
dcterms.bibliographicCitation.pageend500en
dcterms.bibliographicCitation.pagestart491en
dcterms.bibliographicCitation.volume124en
tub.accessrights.dnbfreeen
tub.affiliationFak. 7 Wirtschaft und Management::Inst. Technologie und Management (ITM)::FG Management im Gesundheitswesende
tub.affiliation.facultyFak. 7 Wirtschaft und Managementde
tub.affiliation.groupFG Management im Gesundheitswesende
tub.affiliation.instituteInst. Technologie und Management (ITM)de
tub.publisher.universityorinstitutionTechnische Universität Berlinen

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