Abstract
Empowerment of control and choice of the service users in health and social care has been incorporated into service provision in various countries. This study aimed to elicit the preference of community-based long-term care (LTC) service users on levels of flexibility in service provision. A discrete choice experiment was performed among older community care service users to measure their preference for attributes of LTC services identified from a prior qualitative study. Each participant was asked to make choices in six choice tasks with two alternatives of hypothetical LTC services that were generated from the attributes. A generalized multinomial logistic model was applied to determine the relative importance and willingness to pay for the attributes. It found that the participants preferred multiple flexible providers, determining services by themselves, meeting case managers every month and social workers as sources of information on service provision. Significant preference heterogeneity was found for flexibility in providers and flexibility in services between those with and without activity of daily living impairment. The findings highlighted the preference of older adults for greater flexibility in LTC, while they rely heavily on social workers in decision making. The enhancement of flexibility in LTC should be supported by policies that allow the older service users to make decisions based on their own preferences or communication with social workers instead of determining the services and providers for them. Options should be offered to users to decide their preferred level of flexibility to better reflect their divided preferences.
Highlights
The “money-following-users” approach, which has been implemented in the publicfunded long-term care (LTC) system of Hong Kong, China, since 2013 [1,2], aims to enable service users to gain greater flexibility over their own care arrangement and enable them to stay at home and in the community they are familiar with by providing benefits in the form of a voucher, i.e., a community care service voucher (CCSV)
The users eligible for public-funded LTC service are allowed to choose between traditional in-kind services with determined service providers and service packages and the pilot CCSV scheme adopting novel “money-following-users” approach
The enhancement of flexibility in LTC should be supported by policies and regulations which allow the older participants of relevant programmes to make decisions based on their own preferences or their communication with social workers instead of determining the care arrangement for them, which should be facilitated by a working procedure and guidelines that support the decision-making process of the users
Summary
The “money-following-users” approach, which has been implemented in the publicfunded long-term care (LTC) system of Hong Kong, China, since 2013 [1,2], aims to enable service users to gain greater flexibility over their own care arrangement and enable them to stay at home and in the community they are familiar with (i.e., ageing in place) by providing benefits in the form of a voucher, i.e., a community care service voucher (CCSV)for older adults to purchase home- and community-based LTC services [2,3]. The “money-following-users” approach, which has been implemented in the publicfunded long-term care (LTC) system of Hong Kong, China, since 2013 [1,2], aims to enable service users to gain greater flexibility over their own care arrangement and enable them to stay at home and in the community they are familiar with (i.e., ageing in place) by providing benefits in the form of a voucher, i.e., a community care service voucher (CCSV). The users eligible for public-funded LTC service are allowed to choose between traditional in-kind services with determined service providers and service packages and the pilot CCSV scheme adopting novel “money-following-users” approach. This approach shares a similar concept with “self-directed care” or “consumer-directed care” implemented in several countries in the Organization for Economic Co-operation 4.0/).
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Environmental Research and Public Health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
