As global populations age, governments around the world are investigating how to fund long-term care (LTC) in an equitable and sustainable manner. The research reported here has three objectives: (i) to identify and classify middle-income countries (MICs) and high-income countries (HICs) that have established LTC for older populations; (ii) to describe the financing features and undertake a detailed assessment of the public LTC programmes in these countries; and (iii) to identify and discuss the benefits, disadvantages and challenges of the different public LTC financing strategies, based on the experiences of high-income countries and on observations of the reviewed countries. The public LTC financing system of 13 countries is reviewed: five HICs (Australia, Japan, the Netherlands (Kingdom of the), Singapore and Uruguay), and eight MICs (China, Costa Rica, India, Indonesia, Malaysia, Serbia, South Africa and Thailand). Although information on LTC expenditure is not consistently reported or available for all countries, the 13 reviewed countries vary considerably in terms of their national income, total spending on health and public share of health care spending. This report concludes with some deliberations and lessons learned on financing options for LTC, specifically for low- and middle-income countries. Overall, the report offers valuable insights into how policy-makers can design effective and sustainable public LTC financing systems, ensuring that individuals and their families receive the necessary support and assistance to lead dignified lives as they age.

This brief is part of a series about financing health and social long-term care: lessons for low- and middle-income countries (LMICs). Countries take a universal or selective approach, or some mix of the two, in identifying the population that will be covered under LTC programmes. Decisions are based on the economic and social contexts, and LTC is designed with consideration of the existing infrastructure for delivering health and social care. Universal approaches are grounded in the principle of ensuring equal access to health and social care. Selective approaches focus on those in greatest need, primarily those who are low-income. While selective approaches are perceived to cost less, the total costs may be offset by the high cost of implementing means-testing to identify beneficiaries. The selective approach may also result in high levels of unmet needs among people who do not meet the low-income thresholds. Mixed universal and selective approaches enable universal coverage for some services or populations and means-tested eligibility for others; thus, older people may face high payments for some needed services. Many LMICs have initiated mixed approaches to LTC, using public and private resources while building the policies, systems and infrastructure for universal coverage of LTC.

"This introductory text is a sound, basic overview. It is well structured, and easily accessible both to lay persons, who may have little knowledge or experience of social gerontology, as well as to students who may seek to explore and develop insights further, within what is a relatively recent intellectual tradition." Chrisine Atwell, School of Social Sciences, Cardiff University, UK “Ageing Societies: A Comparative Introduction provides a comprehensive introduction to the field of ageing, highlighting the inter-connections between health, economic and social aspects of ageing. Virpi Timonen’s book is written in a lively and accessible style and will be particularly valuable for undergraduates and students on professional courses. “ Sara Arber, University of Surrey, UK "Timonen does an excellent job of explaining both very basic concepts and complex aspects, thus making this book accessible to a broad range of readers. There are only very few exceptions where this is neglected. Overall, therefore, this is a very balanced approach to an important and vast subject area that manages to balance a social critique that calls us to address and adapt ageing socially, politically and economically, with an optimistic view of the achievements and opportunities that these developments bring with them." VANESSA BECKUniversity of Leicester "It is very refreshing to read a book which achieves the delicate balance between celebrating age and ageing without losing the message that there are distinct biological, psychological and social challenges for older people in all societies ... The volume is well written in a jargon-free, lively and accessible style, and any necessary acronyms and technical vocabulary are fully explained to the reader ...I have no doubt that the book will be of interest to both undergraduate and postgraduate students in fields such as gerontology, social policy, social work, sociology, nursing, as well as professionals and practitioners who work with older people. Timonen provides a clear, well-organised, wide-ranging and comprehensible introduction to the complex and highly topical subject of ageing and its global and social diversity." KATE DAVIDSONCentre for Research on Ageing and Gender,University of Surrey, Guildford, UK What is ageing? Why is ageing important and how can we understand it better? How does policy and practice in relation to ageing populations differ across the globe? This book aims to convince readers that ageing is not boring, threatening or depressing, but that it has enormous relevance for the young and the old alike. Virpi Timonen provides an engaging introduction to the central social, economic and political aspects and impacts of ageing and makes the case for the importance of analysing ageing from a number of different perspectives. Using comparative international data, the author provides a detailed description of the process of population ageing, including increasing longevity, changes in fertility and variations in the health status of older populations. In addition, the book sets out the social context and background of ageing, discussing related and relevant developments, such as: Changes in family structures Patterns of household formation Women’s labour market participation Income and work in older age Health and social care of older people Attitudes towards older people The book highlights the nature of ageing as an individual and societal experience. The author succeeds in arguing that whilst ageing is becoming an increasingly widespread and global experience, age-related policies, practices and consequently the actual lived experience of ageing differ greatly between countries and regions of the world. Ageing Societies is of interest and use to both undergraduate and postgraduate students in fields such as gerontology, social policy, social work, sociology, nursing, as well as professionals and practitioners in the eldercare sectors and general readers from a wide variety of backgrounds who wish to gain an understanding of the complex and highly topical subject of ageing.

"A companion volume to: Public Office, Private Interests: Accountability Through Income and Asset Disclosure."

This overview of health financing tools, policies and trends--with a particular focus on challenges facing developing countries--provides the basis for effective policy-making. Analyzing the current global environment, the book discusses health financing goals in the context of both the underlying health, demographic, social, economic, political and demographic analytics as well as the institutional realities faced by developing countries, and assesses policy options in the context of global evidence, the international aid architecture, cross-sectoral interactions, and countries' macroeconomic frameworks and overall development plans.

Health financing is a core pillar of health systems and encompasses the three functions of how revenues for health are collected, pooled and paid out to providers of health care services. It can be leveraged to pursue key universal health coverage goals of enhancing access, ensuring quality and financial protection against catastrophic or impoverishing out-of-pocket expenditure. But knowledge on how health financing practices can be harnessed to promote the delivery of rehabilitation services is limited. This document is the first WHO resource on health financing for rehabilitation. It considers current practices for financing rehabilitation services, frames major challenges and opportunities, and offers guidance to decision-makers engaged in strengthening rehabilitation within health systems.

Beyond the Annual Budget is a comprehensive review of country experience with Medium Term Expenditure Frameworks (MTEFs) worldwide. It looks at countries both with and without MTEFs over the period 1990 to 2008 to obtain results about their impact on fiscal performance.

This short paper reviews recent literature on the use of long-term finance in developing economies (relative to advanced ones) to identify where long-term financing occurs, and what role different financial intermediaries and markets play in extending this type of financing. Although banks are the most important providers of credit, they do not seem to offer long-term financing. Capital markets have grown since the 1990s and can provide financing at fairly long terms. But few firms use these markets. Only some institutional investors provide funding at long-term maturities. Governments might help to expand long-term financing, although with limited policy tools.

This title was first published in 2000. An up-to-date overview of the systems of social protection for the elderly in the fifteen EU states and Norway. The book also offers a comprehensive comparative analysis of the residential, semi-residential and community services available and explores the debates surrounding policy reform of the social protection system of dependent older persons.