Abstract
Dementia care resources in Taiwan have not been allocated taking into account patients’ needs and the distance between service users and providers. The objective of this study was to use two newly developed indicators; profit willing distance (PWD) and tolerance limited distance (TLD), to profile the service availability and accessibility of the 22 administrative areas in Taiwan and facilitate justice-based resource allocation by the central government. The study employed secondary data analysis by using a geographic information system (GIS) and geocoding to identify distances between service users and providers. The study samples were drawn from the databank of the National Disability Eligibility Determination System and grouped by the acuteness of registrants’ needs. Both the PWD and TLD were found in 15 of the administrative areas, and neither was found in three areas (Penghu, Kinmen, and Lienchiang County). Either the PWD or TLD (but not both) were found in four areas (only have PWD: Hsinchu and Chiayi City; only have TLD: Yunlin and Taitung County). How the priorities should be set for dementia service allocation based on these findings was also addressed. We conclude that the indicators of PWD and TLD can add value to the policy decision-making process, help set priorities, and facilitate efficient and fair resource allocation by defining specifics of the resources needed.
Highlights
According to the World Alzheimer Report 2018 and cross-national surveys, there were over 10 million new cases of dementia in 2017, with an average of one dementia case every three seconds.It was estimated that the number of patients with dementia would reach 131.5 million by 2050 [1,2].It was estimated that the cost spent on dementia care in 2015 would have been USA $818 billion, and by 2018 it would exceed USA $1 trillion [1]
Given the limited resources of long-term care, the central government has the responsibility of ensuring that national resources for dementia care are allocated based on distributive justice in order to meet the needs of patients with dementia and their families [4,5,6]
Whether or not existing resources are sufficient can be determined by measuring the profit willing distance (PWD) and tolerance limited distance (TLD) and comparing the TLDs of different administrative areas to guide the central government on where to set up related resources
Summary
According to the World Alzheimer Report 2018 and cross-national surveys, there were over 10 million new cases of dementia in 2017, with an average of one dementia case every three seconds.It was estimated that the number of patients with dementia would reach 131.5 million by 2050 [1,2].It was estimated that the cost spent on dementia care in 2015 would have been USA $818 billion, and by 2018 it would exceed USA $1 trillion [1]. It was estimated that the number of patients with dementia would reach 131.5 million by 2050 [1,2]. In 2017, the total population of dementia was estimated to be over 270,000 which was larger than the total population of Changhua City (population: 235,000), and the population of dementia who would need care could reach more than 850,000 in 40 years [3]. Given the limited resources of long-term care, the central government has the responsibility of ensuring that national resources for dementia care are allocated based on distributive justice in order to meet the needs of patients with dementia and their families [4,5,6]
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