Long-Term Care Models in Select OECD Countries and Policy Implications for Canada: A Focused Qualitative Systematic Review

Abstract

The COVID-19 pandemic highlighted many problems with Canada's older adults (OA) long-term care (LTC) model. The demographic changes in the next two decades require a novel approach to LTC. This study aimed to conduct a focused qualitative systematic review (SR) of the publicly supported LTC models and policies in select advanced economies. The authors used PubMed, Embase, and Medline to conduct an SR following the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) 2020 guidelines. Fully published articles in the English language related to LTC for Germany, Sweden, Australia, Denmark, France, and the Netherlands were included. Predefined data on the LTC models, including eligibility criteria, coverage, funding, and delivery methods, were extracted. Out of 1,682 screened articles/websites, 28 publications, websites, and reports were included. Despite differences in LTC models, there were two primary funding sources for LTC in the selected countries: general tax and LTC insurance. Aligned with the OAs preference, there was an emphasis on providing LTC at home. The care services were need-based and often defined by healthcare professionals or specialized teams. To address the growing number of OAs and to fulfill their needs, the Canadian LTC system requires a major shift to LTC at home and keeping the institutional LTC as the last resource. A sustainable LTC at home also requires a new legislative framework and financial levers.