Skip to main content
Log in

International long-term care reform: A demographic, economic, and policy overview

  • Published:
Journal of Cross-Cultural Gerontology Aims and scope Submit manuscript

Abstract

Advanced industrial countries around the world are making or contemplating major reforms of their systems for financing and organizing long-term care for the elderly. The paper describes major reform efforts including: the pursuit of cost efficiencies from further differentiation of the acute and long-term care delivery systems, promotion of home and community-based care alternatives to traditional institutions, and ‘systems integration’ involving consolidation of responsibility for long-term care at one level of government. The paper concludes by discussing the special relevance to the longterm care reform debate in the U.S. of recent British and German decisions to, respectively, decentralize versus centralize responsibility for long-term care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Baldock, J. and A. Evers 1991 (June) Innovations and Care of the Elderly: The Front Line of Change for Social Welfare Services. Ageing International 28 (1): 8–21.

    Google Scholar 

  • Davies, B. and D. Challis 1986 Matching Resources to Needs in Community Care: An Evaluated Demonstration of a Long-Term Care Model. Aldershot, Hants, England: Gower Publishing Company.

    Google Scholar 

  • Myers, George C., B.B. Torrey and K. Kinsella 1992 The Paradox of the Oldest Old in the United States: An International Comparison. In The Oldest Old. R.M. Suzman, D.P. Willis, and K.G. Manton, eds., Oxford, England: Oxford University Press.

    Google Scholar 

  • Rivlin, A. and J. Wiener 1988 Caring for the Disabled Elderly: Who Will Pay? Washington, D.C.: Brookings Institution.

    Google Scholar 

  • Wiley, M.M. 1992 Hospital Financing Reform and Case-mix Measurement: An International Review. Health Care Financing Review 13(4): 119–133.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This paper should not be construed in any way as reflecting or representing official views of the U.S. Department of Health and Human Services.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Doty, P. International long-term care reform: A demographic, economic, and policy overview. J Cross-Cultural Gerontol 8, 447–461 (1993). https://doi.org/10.1007/BF00972571

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00972571

Key Words

Navigation