Developing a framework for performance assessment of the public long-term care system in Korea: methodological and policy lessons

Hongsoo Kim,Boyoung Jeon

doi:10.1186/s12961-020-0529-8

Abstract

BackgroundLimited evidence exists on how to assess long-term care system performance. This study aims to report on the process and results of developing a performance assessment framework to evaluate the long-term care system financed by the public long-term care insurance in South Korea.MethodsThe framework was developed through a six-step approach, including setting the goals and scope of performance assessment in the given policy context, reviewing existing performance frameworks, developing a framework with a wide range of potential indicators, refining the framework through a series of Delphi surveys and expert meetings, examining the feasibility of generated indicators through a pilot test, receiving the comments of stakeholders, and finalising the performance framework.ResultsThe finalised framework has 4 domains – coverage, quality of care, quality of life and system sustainability – and 28 indicators, including 10 core indicators to monitor long-term care system performance. Usability and feasibility along with policy relevance were important criteria in selecting these indicators. The proposed framework can be used to assess the performance of the long-term care system in Korea, and the framework and its methodological approach can be benchmarks for other countries developing their own framework.ConclusionsIt is critical to reconcile and prioritise various stakeholders’ views and information needs as well as to balance methodological rigor with practical usefulness and feasibility in the development and implementation of a long-term care performance monitoring system.

Highlights

South Korea is a country with one of the most rapidly aging populations in the world
We reviewed some indicators for long-term care (LTC) systems in health system performance assessment (HSPA) frameworks, as an LTC system is often regarded as part of the health system in a country [25, 26]
The proposed framework of LTC system performance assessment: goals, domains and indicators The proposed framework for performance assessment of the LTC system under the public long-term care insurance (LTCI) in Korea consists of a goal, four domains and 28 indicators (Table 1)

Summary

Introduction

Background South Korea is a country with one of the most rapidly aging populations in the world. In Korea, an Asian country that values filial piety, caring for older family members is considered the most important family responsibility and Responding to the increasing social responsibility for caregiving to the older population, a public long-term care (LTC) system financed by a social long-term care insurance (LTCI) scheme was introduced in 2008. Developing a performance framework including internationally relevant indicators could allow the monitoring of its performance in a comparative way with other countries that have similar LTC systems; this could facilitate crossnational policy learning and evaluation.

Objectives

Methods

Results

Discussion

Conclusion