Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries (CROSBI ID 284704)
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Waitzberg, Ruth ; Schmidt, Andrea E. ; Blümel, Miriam ; Penneau, Anne ; Farmakas, Antonis ; Ljungvall, Åsa ; Barbabella, Francesco ; Augusto, Gonçalo Figueiredo ; Marchildon, Gregory P. ; Saunes, Ingrid Sperre ; Vočanec, Dorja ; Miloš, Iva ; Contel, Joan Carles ; Murauskiene, Liubove ; Kroneman, Madelon ; Tambor, Marzena ; Hroboň, Pavel ; Wittenberg, Raphael ; Allin, Sara ; Or, Zeynep
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Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries
Introduction Long-term care (LTC) is organized in a fragmented manner. Payer agencies (PA) receive LTC funds from the agency collecting funds, and commission services. Yet, distributional equity (DE) across PAs, a precondition to geographical equity of access to LTC, has received limited attention. We conceptualize that LTC systems promote DE when they are designed to set eligibility criteria nationally (vs. locally) ; and to distribute funds among PAs based on needs- formula (vs. past-budgets or government decisions). Objectives This cross-country study highlights to what extent different LTC systems are designed to promote DE across PAs, and the parameters used in allocation formulae. Methods Qualitative data were collected through a questionnaire filled by experts from 17 OECD countries. Results 11 out of 25 LTC systems analyzed, fully meet DE as we defined. 5 systems which give high autonomy to PAs have designs with low levels of DE ; while nine systems partially promote DE. Allocation formulae vary in their complexity as some systems use simple demographic parameters while others apply socio-economic status, disability, and LTC cost variations. Discussion and conclusions A minority of LTC systems fully meet DE, which is only one of the criteria in allocation of LTC resources. Some systems prefer local priority-setting and governance over DE. Countries that value DE should harmonize the eligibility criteria at the national level and allocate funds according to needs across regions.
Long-term care ; EquityFunds allocation ; Payer agencies ; Allocation formula
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