Effects Of Long-term Care Insurance Research Articles

Indirect Fiscal Effects of Long-Term Care Insurance

Informal care by close family members is the main pillar of most longterm care systems. However, due to demographic ageing the need for long-term care is expected to increase while the informal care potential is expected to decline. From a budgetary perspective, informal care is often viewed as a cost-saving alternative to subsidized formal care. This view, however neglects that many family carers are of working age and face the difficulty to reconcile care and paid work which might entail sizable indirect fiscal effects related to forgone tax revenues, lower social security contributions and higher transfer payments. In this paper we use a structural model of labor supply and the choice of care arrangement to quantify these indirect fiscal effects of informal care. Moreover based on the model we discuss the fiscal effects related to non-take up of formal care.

Indirect Fiscal Effects of Long-Term Care Insurance

Informal care by close family members is the main pillar of most longterm care systems. However, due to demographic ageing the need for long-term care is expected to increase while the informal care potential is expected to decline. From a budgetary perspective, informal care is often viewed as a cost-saving alternative to subsidized formal care. This view, however neglects that many family carers are of working age and face the difficulty to reconcile care and paid work which might entail sizable indirect fiscal effects related to forgone tax revenues, lower social security contributions and higher transfer payments. In this paper we use a structural model of labor supply and the choice of care arrangement to quantify these indirect fiscal effects of informal care. Moreover based on the model we discuss the fiscal effects related to non-take up of formal care.

Does long-term care insurance affect the length of stay in hospitals for the elderly in Korea?: a difference-in-difference method.

BackgroundThis study examines the effects of long-term care insurance (LTCI) on the length of stay (LoS) of senior citizens under the national health insurance of Korea.MethodsThe subjects include 3,903,448 people aged 65 and over as of July 1, 2008 when the LTCI was introduced in Korea. This study uses their panel data which traced the records of medical services and LTCI services for the same people from 2007 to 2010, and applies a difference-in-difference approach on LTCI users from levels 1, 2, and 3 who are the treatment group and non-LTCI users who are the control group.ResultsWe found that the LoS of LTCI users is 1.27 days greater than that of non-LTCI users, but the LoS of level 1 and level 2 beneficiaries decreases by 8.35 and 2.84 days, respectively, whereas the LTCI does not reduce the LoS of level 3 beneficiaries.ConclusionsThe reason why there is an effect on the LoS of level 1 and 2 beneficiaries is that these groups could choose to utilize institutional care services provided by the LTCI, and out-of-pocket costs of institutions are lower than that of hospitals. However, the reason why there is no effect on the LoS of level 3 beneficiaries is that they are not permitted to use the institutional care services in the Korean LTCI policy. Therefore, we recommend a modification in the LTCI system that facilitates the use of long-term care institutional services by level 3 beneficiaries without conflicting Korea’s LTCI principle to promote home-based care services instead of the institutional care services.

The Effect of Long-Term Care Insurance on Home Care Use Among the Disabled Elders

Using the 1998–2004 Health and Retirement Study, this study uses Cox’s model to explore the effects of private long-term care insurance ownership on first home care use among the disabled elderly. Results show that long-term care insurance ownership and Medicaid eligibility did not significantly increase the likelihood of using home care services, while income and homeownership lowered this likelihood. Functional limitation was the key determinant of home care use and those who lived with children were less likely to use home care services. Based on the findings, this study provides foundations for long-term care policies and long-term care planning programs.

The Effects of Long-term Care Insurance on the Life Satisfaction and Satisfaction in Family Relationships - The DD Method Combined with Propensity Score Matching -

이 연구는 우리나라 노인장기요양보험의 제도성과를 평가하는데 그 목적이 있다. 정확한 제도성과를 추정하기 위하여 준실험적 방법인 성향점수매칭과 이중차이 결합모형을 이용해 타당성을 저해할 수 있는 요인들을 제거하였다. 노인장기요양보험제도가 사회적 성과변수인 대상노인과 부양가족의 삶의 질과 가족관계 만족도에 미치는 영향을 분석하기 위해 한국복지패널 3-4차 조사자료를 이용하여 성향점수추정을 통해 실험집단과 비교집단을 매칭한 후, 정책시행 이전과 이후 실험집단과 비교집단 간의 성과의 차이를 추정하기 위해 패널고정효과모형을 이용한 이중차이분석을 실시하였다. 그 결과, 노인장기요양보험제도의 대상노인과 부양가족의 삶의 질은 통계적으로 유의미하지 않았고, 가족관계 만족도는 제도시행 이전에 비해 제도시행 이후 향상된 것을 확인할 수 있었다. 이러한 결과는 노인장기요양보험이 실시되고 제도가 충분히 성숙된 시점에 이루어진 평가가 아니라는 한계점을 가지지만, 노인장기요양보험제도의 최종 목표인 대상노인과 부양가족의 삶의 질 향상이라는 정책의 목표실현과 향후 제도개선에 있어서 중요한 함의를 가진다.

On the consumption insurance effects of long-term care insurance in Japan: Evidence from micro-level household data

Using micro-level household data in the 2001 Comprehensive Survey of the Living Conditions of the People on Health and Welfare compiled by the Japanese Ministry of Health, Labor and Welfare, this paper examines how having a household member in need of long-term nursing care can result in welfare losses measured in terms of consumption. In so doing, this study evaluates the role of the public long-term care insurance scheme implemented in Japan in April 2000. The results indicate that when households include a disabled family member, household consumption net of long-term care costs do not decrease as much as before the introduction of long-term care insurance. Further, when compared with the surveys conducted in 1998, the adverse effects on consumption net of long-term care costs have become much weaker. These findings suggest that the introduction of social insurance in 2000 helped Japanese households to reduce the welfare losses associated with a disabled family member.

Effect of long-term care insurance on communication/recording tasks for in-home nursing care services

The purpose of this research was to clarify the possible changes brought about by the introduction of the long-term care insurance system in terms of number of communication/recording tasks, related nursing services in use, and when and where these tasks were performed. By examining the detailed content of communication/recording tasks, this study also sought to explore the advantages of introducing information technology (IT) systems in nursing service settings. The study was designed before-and-after study in two sessions, February 2000 and August 2000, namely before and after the introduction of Japan’s long-term care insurance system. Participants were clients using the institution’s in-home nursing services and all staff in a medical institution located in the Mikawa region of Aichi Prefecture, Japan. Following measurements were performed: (1) nursing service in use, (2) type of job, (3) date and time, (4) from whom, (5) to whom, (6) communication tool and (7) content, related to a particular communication. Communication/recording tasks were frequently performed around the starting and closing time of services. Following the adoption of the new system, these tasks tended to occur mostly around the starting time of services. As for the staff, the involvement of the professional carers increased. Regarding content of communication/recording, reports, confirmation and instruction increased. In conclusion, the use of IT driven devices is recommended to streamline the performance of communication/recording tasks as well as to ease the rush of these tasks thereby improving the quality of nursing services.