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From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country
BACKGROUND: Taiwan, one of the fastest-aging countries in the world, started implementing version 1.0 of its long-term care (LTC) plan in 2008. In 2017, LTC Plan 2.0 began a new era with its goal to integrate Taiwan’s fragmented LTC service system. LTC Plan 2.0 also aims to establish an integrated c...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555737/ https://www.ncbi.nlm.nih.gov/pubmed/31174477 http://dx.doi.org/10.1186/s12877-019-1172-5 |
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author | Chiu, Tzu-Ying Yu, Hsiao-Wei Goto, Rei Lai, Wen-Lin Li, Hsi-Chang Tsai, En-Tien Chen, Ya-Mei |
author_facet | Chiu, Tzu-Ying Yu, Hsiao-Wei Goto, Rei Lai, Wen-Lin Li, Hsi-Chang Tsai, En-Tien Chen, Ya-Mei |
author_sort | Chiu, Tzu-Ying |
collection | PubMed |
description | BACKGROUND: Taiwan, one of the fastest-aging countries in the world, started implementing version 1.0 of its long-term care (LTC) plan in 2008. In 2017, LTC Plan 2.0 began a new era with its goal to integrate Taiwan’s fragmented LTC service system. LTC Plan 2.0 also aims to establish an integrated community-based LTC system incorporating both health care and disability prevention. This three-tier model consists of the following: two LTC services with a day-care center as their base and case management (Tier A), a day-care center and a single LTC service (Tier B), and LTC stations that provide primary prevention services and respite services for frail community-dwelling older adults to prevent further disabilities (Tier C). A defined cluster of agencies in a local area works together as a Tier ABC team. LTC Plan 2.0 is a new policy for Taiwan, and hence it is important to understand the agencies’ initial difficulties with implementation and identify future challenges to help further policy development. METHODS: This preliminary study explored the challenges to implementing LTC 2.0 through in-depth interviews based on Evashwick’s integration mechanisms with representatives from three service teams. We interviewed three chief executive officers and three case managers. RESULTS: We found that the LTC Plan 2.0 mechanisms for service integration have been insufficiently implemented. Recommendations include (1) Build up the trust between agencies and government, avoid duplication of LTC services within Tier ABC team, and encourage agencies within a team to create a shared administrative system with the same mission and vision. (2) Clarify the roles and responsibilities of government care managers and agency case managers. (3) Provide an integrated information system and create an official platform for sharing client records across different agencies and caregivers. (4) Establish a tool and platform to track the budget and payment across different levels of service as soon as possible. CONCLUSION: There is an increased demand for LTC services in Taiwan because of its rapidly aging population. Our findings shed some light on the challenges to developing integrated LTC services and thus may help both policymakers and service providers find ways to overcome these challenges. |
format | Online Article Text |
id | pubmed-6555737 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65557372019-06-10 From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country Chiu, Tzu-Ying Yu, Hsiao-Wei Goto, Rei Lai, Wen-Lin Li, Hsi-Chang Tsai, En-Tien Chen, Ya-Mei BMC Geriatr Research Article BACKGROUND: Taiwan, one of the fastest-aging countries in the world, started implementing version 1.0 of its long-term care (LTC) plan in 2008. In 2017, LTC Plan 2.0 began a new era with its goal to integrate Taiwan’s fragmented LTC service system. LTC Plan 2.0 also aims to establish an integrated community-based LTC system incorporating both health care and disability prevention. This three-tier model consists of the following: two LTC services with a day-care center as their base and case management (Tier A), a day-care center and a single LTC service (Tier B), and LTC stations that provide primary prevention services and respite services for frail community-dwelling older adults to prevent further disabilities (Tier C). A defined cluster of agencies in a local area works together as a Tier ABC team. LTC Plan 2.0 is a new policy for Taiwan, and hence it is important to understand the agencies’ initial difficulties with implementation and identify future challenges to help further policy development. METHODS: This preliminary study explored the challenges to implementing LTC 2.0 through in-depth interviews based on Evashwick’s integration mechanisms with representatives from three service teams. We interviewed three chief executive officers and three case managers. RESULTS: We found that the LTC Plan 2.0 mechanisms for service integration have been insufficiently implemented. Recommendations include (1) Build up the trust between agencies and government, avoid duplication of LTC services within Tier ABC team, and encourage agencies within a team to create a shared administrative system with the same mission and vision. (2) Clarify the roles and responsibilities of government care managers and agency case managers. (3) Provide an integrated information system and create an official platform for sharing client records across different agencies and caregivers. (4) Establish a tool and platform to track the budget and payment across different levels of service as soon as possible. CONCLUSION: There is an increased demand for LTC services in Taiwan because of its rapidly aging population. Our findings shed some light on the challenges to developing integrated LTC services and thus may help both policymakers and service providers find ways to overcome these challenges. BioMed Central 2019-06-07 /pmc/articles/PMC6555737/ /pubmed/31174477 http://dx.doi.org/10.1186/s12877-019-1172-5 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Chiu, Tzu-Ying Yu, Hsiao-Wei Goto, Rei Lai, Wen-Lin Li, Hsi-Chang Tsai, En-Tien Chen, Ya-Mei From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country |
title | From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country |
title_full | From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country |
title_fullStr | From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country |
title_full_unstemmed | From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country |
title_short | From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country |
title_sort | from fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555737/ https://www.ncbi.nlm.nih.gov/pubmed/31174477 http://dx.doi.org/10.1186/s12877-019-1172-5 |
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