Key policy issues in long-term care (LTC) are complex and the numbers of persons needing such care continue to incease. This volume addresses these issues: the role of and support to the family; integration with health and social systems; case management; and strategies for designing LTC systems.

Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.

The past fifteen years have seen longterm care policies in the countries of the Organization for Economic Co-operation and Development (OECD) undergo substantial transformations, either through major policy reforms or through accumulated minor policy changes. This book brings together data from many OECD countries to compare key changes in national policies, examine the successes or failures of new approaches, and offer policy strategies for the future. Drawing on fifteen years of evidence and bringing together contributors from a number of perspectives throughout the OECD, it will be essential for those studying--or making--policy.

"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

Attitudes toward long-term care contain a strong residue of negativity in today‘s society and current problems with the system augment such perceptions. Unless dealt with now, this will only get worse, as the 85-and-older crowd is the fastest growing part of the population, and the first wave of Baby Boomers is approaching 60. Exploring and delinea

Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.

Health care reform has dominated public discourse over the past several years, and the recent passage of the Affordable Care Act, rather than quell the rhetoric, has sparked even more debate. Donald A. Barr reviews the current structure of the American health care system, describing the historical and political contexts in which it developed and the core policy issues that continue to confront us today. This comprehensive analysis introduces the various organizations and institutions that make the U.S. health care system work—or fail to work, as the case may be. A principal message of the book is the seeming paradox of the quality of health care in this country—on the one hand it is the best medical care system in the world, on the other it is one of the worst among developed countries because of how it is organized. Barr introduces readers to broad cultural issues surrounding health care policy, such as access, affordability, and quality. He discusses specific elements of U.S. health care, including insurance, especially Medicare and Medicaid, the shift to for-profit managed care, the pharmaceutical industry, issues of long-term care, the plight of the uninsured, medical errors, and nursing shortages. The latest edition of this widely adopted text updates the description and discussion of key sectors of America’s health care system in light of the Affordable Care Act.

Who pays for long-term care? Discover the unique approaches of seven countries around the Pacific Rim! Long-Term Care in the Twenty-First Century discusses policies and programs for long-term care in seven countries around the Asia-Pacific Rim: the United States, Canada, Japan, Australia, Singapore, Hong Kong, and Taiwan. Each country is covered in two chapters, one to examine the philosophy and values that underlie its approaches to long-term care, the second to discuss its systems of service delivery. These thoughtful analyses, backed up with facts and figures, explain program successes and failures in the context of demographic and social trends and with reference to the differing political systems across the region. Its breadth of perspective and insightful examination of cultural differences make Long-Term Care in the Twenty-First Century an important contribution to the international comparative study of aging. The programs in the United States, Australia, and Canada offer a fascinating contrast with the longer-established and very different programs in the Asian countries, including Japan, the world’s oldest country. Long-Term Care in the Twenty-First Century provides practical information on essential gerontological issues for each country, including: financing arrangements development of client classification systems case management in both residential and community-based systems key source documents, references, and Web sites political and cultural influences home-based and family caregiving This valuable book provides a critical record of developments in the current transition period. This multicultural perspective contributes a chance for all countries to learn from the experience of others in dealing with a problem that is increasingly important as the world population ages. Long-Term Care in the Twenty-First Century is an essential resource for scholars, service providers, policymakers, and anyone concerned with care of the aged, not only in Pacific Rim countries but around the world.

Shared concerns and key policy issues regarding long-term care in Australia and the United States are reviewed. The demographics and government structures of Australia and the United States are compared. Also reviews the overall structure of each country's long term care system, the interrelationships among components and inherent incentives and disincentives. Lastly, examines costs and institutionalization rates.