Abstract
In response to the irreversible aging trend, the Taiwan government has promoted the Long-Term Care (LTC) policy 1.0 launched in 2007 and the LTC policy 2.0 reform since 2016. This study aimed to explore the utilization of formal home and community-based care under LTC policy 1.0 to add scientific support for the on-going LTC policy 2.0 reform. Methods: By using Andersen and Aday’s behavioral model of healthcare utilization, the long-term care dataset was analyzed from 2013 to 2016. A total of 101,457 care recipients were identified after data cleaning. Results: The results revealed that about 40.7% of the care recipients stayed in the care system for more than two years. A common factor influencing the length of home and community-based services (HCBS) utilization period included need factors, where more dependent recipients leave the LTC system regardless of their socio-economic status. However, the utilization period of non-low-income households is significantly affected by the level of service resources. Conclusion: For long-term care needs, the phenomenon of a short utilization period was concerning. This study adds information which suggests policy should reconsider care capacity and quality, especially for moderate to severely dependent recipients. This will allow for better understanding to help maintain care recipients in their own communities to achieve the goal of having an aging in place policy.
Highlights
IntroductionHealth Organization (WHO) standards, Taiwan has been an aged society, where the proportion of the population aged 65 and older accounts for over 14% of the overall population since 2018
Population aging in Taiwan is part of a worldwide phenomenon
The results showed that gender, age, having a primary caregiver, body mass index (BMI), dependency levels, IADL function, and mental status were all significant influencing factors in each household group, while depression, service resources level, and proportion of certified nursing aides (CNAs) affected those in non-low-income households
Summary
Health Organization (WHO) standards, Taiwan has been an aged society, where the proportion of the population aged 65 and older accounts for over 14% of the overall population since 2018 It may only take eight years for Taiwan to advance from an aged society to a "super-aged society" in 2026, which means the aging rate exceeds 21% [1]. Since life expectancy in Taiwan extended to 80.2 years in 2015 from an estimated healthy life expectancy (HALE) of 71 years in 2014, elderly people may have to rely on others for care for an average of nine years [2] This situation has caused major fiscal issues and has made sustainability of long-term care a policy priority [3]
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