Query: long-term care insurance role

title: Government Responsibility in Long Term Care Insurance Experience Difficulties and Future Choices
abstract: At present, China's family care function is weakening, but the demand for nursing is rising rapidly. It is imperative to establish a long term care insurance system based on the experience of other countries. In this process, government responsibility plays a key role in the top level design of the system and in all aspects of its implementation. This paper first introduces the advanced experience of Japan and South Korea, which belongs to the East Asian welfare model, then analyzes the difficulties faced by China in the system pilot, and then explores the responsibility of the government in building a long term care insurance system suitable for China's national conditions.

title: [Investigation of the actual conditions of users of a home visiting bathing service based on the long term care insurance care ranking and factors affecting the judgment of bathing possibility]
abstract: In home visiting bathing services (HVBs) a nurse's role is to evaluate the vital signs, judge bathing possibilities and provide treatment before/after bathing. There are no guidelines regarding specific physical criteria for judging the bathing possibility. However, the body condition of HVB users during bathing has not been investigated. Thus, the present study aimed to clarify users' actual conditions and the factors related to the judgment of the possibility of bathing.  An anonymous self administered questionnaire survey of HVBs users was conducted by Company A, which provides HVBs. Six hundred sixty responses were collected (response rate: 40.1%.We described the conditions of HVB users and used chi squared tests and logistic regression analyses to confirm the factors, including the certified Long term Care Insurance (LTCI) care rank, past medical history and physical conditions that were associated with aborted HVB experiences.  The mean age of the care recipients was 82.1+ 12.1 and 93.3% of the recipients had severe conditions, including conditions necessitation the use of medical equipment, pressure ulcers, and contracture. The logistic regression analysis showed that the LTCI certified care rank, the presence of pain, and the need for treatment before bathing were significant factors.  This study showed that users of HVBs not only had high LTCI certified care ranks, but that they also required pain management and pre bathing treatment.

title: The role of life experience in long term care insurance decisions
abstract: This study uses data from a unique survey of the retirement planning behaviors of late middle aged individuals living in New York State, to test hypotheses regarding the role of earlier life experiences on the demand for long term care insurance. Our primary focus is on previous provision of informal long term care, which some studies have found to be correlated with demand for long term care insurance. We add to the literature by providing a test for causal relationships between previous care giving and insurance demand, and by exploring the more generally the mechanisms through which previous life experiences are linked to insurance demand. Results are robust to a variety of empirical specifications and estimation methods, including consideration of current care giving roles and endogenous selection into previous care giving, and strongly support a causal relationship between previous long term care giving and demand for insurance. Our estimates also provide evidence that lifetime health trajectories and family relationships are associated with long term care insurance demand, and suggest that both emotional and informational forces influence demand.

title: The Recognition of Occupational Therapists Role and the Amended Act of Long Term Care Insurance for the Aged

title: Role of race and ethnicity in private long term care insurance ownership.
abstract: To determine if racial/ethnic disparities exist in the ownership of private long term care insurance (LTCI) among current Medicare beneficiaries.  This study used the 2011 wave of the National Health and Aging Trends Study. Bivariate analysis and multivariate logistic regression were employed to isolate the independent effects of race/ethnicity on LTCI uptake. Stratified multivariate analyses were used to further examine the effect of race/ethnicity on LTCI ownership.  12.3% of Blacks and 5.8% of Hispanics, compared with 20.2% of Whites (p .001) reported having LTCI coverage. We found that Hispanics were 48% less likely to have LTCI (p .005) compared with Whites, whereas no difference was found between Blacks and Whites. Compared with White women, Hispanic women were 81% less likely to be insured (p .001) Ethnic disparities persisted among individuals who, based on income and assets, are considered appropriate for purchasing private LTCI coverage.  This study demonstrates that ethnic differences exist in the ownership of LTCI among elderly Americans. Additional research is needed to determine what factors are responsible for the apparent underrepresentation of Hispanics in the LTCI market.

title: The Role of the Health and Welfare Committee in the Legislative Process of the Social Security Act: The Case of the Act on Long Term Care Insurance for the Aged
abstract: The Role of the Health and Welfare Committee in the Legislative Process of the Social Security Act: The Case of the Act on Long Term Care Insurance.

title: Excess costs of dementia disorders and the role of age and gender an analysis of German health and long term care insurance claims data
abstract: BackgroundDemographic ageing is associated with an increasing number of dementia patients, who reportedly incur higher costs of care than individuals without dementia. Regarding Germany, evidence on these excess costs is scarce. Adopting a payer perspective, our study aimed to quantify the additional yearly expenditures per dementia patient for various health and long term care services. Additionally, we sought to identify gender specific cost patterns and to describe age dependent cost profiles.MethodsThe analyses used 2006 claims data from the AOK Bavaria Statutory Health Insurance fund of 9,147 dementia patients and 29,741 age and gender matched control subjects. Cost predictions based on two part regression models adjusted for age and gender and excess costs of dementia care refer to the difference in model estimated means between both groups. Corresponding analyses were performed stratified for gender. Finally, a potentially non linear association between age and costs was investigated within a generalized additive model.ResultsYearly spending within the social security system was circa EUR12,300 per dementia patient and circa EUR4,000 per non demented control subject. About two thirds of the additional expenditure for dementia patients occurred in the long term care sector. Within our study sample, male and female dementia patients incurred comparable total costs. However, women accounted for significantly lower health and significantly higher long term care expenditures. Long term care spending increased in older age, whereupon health care spending decreased. Thus, at more advanced ages, women incurred greater costs than men of the same age.ConclusionsDementia poses a substantial additional burden to the German social security system, with the long term care sector being more seriously challenged than the health care sector. Our results suggest that female dementia patients need to be seen as a key target group for health services research in an ageing society. It seems clear that strategies enabling community based care for this vulnerable population might contribute to lowering the financial burden caused by dementia. This would allow for the sustaining of comprehensive dementia care within the social security system.

title: Role of Healthcare in Korean Long Term Care Insurance
abstract: With the rapid aging of the population, Korea introduced public long term care insurance for older people in 2008. The long term care insurance was designed as a separate scheme from the national health insurance, with eligibility qualifications and the certification process based on functional disability, benefits and coverage of community based and institutional care, and a financing structure through multi party contributions. Delivering appropriate health services to long term care beneficiaries who manifest a high prevalence of comorbid chronic conditions with rising healthcare costs, however, presents a particular challenge. The lack of coordination between the health and long term care sectors, limited consideration of physicians' assessments in the certification process, inadequate provision of health services in long term care facilities, and overlapping and inefficient use of care resources act as barriers to providing comprehensive healthcare for older beneficiaries. Through active participation in the long term care system, health professionals can help older patients navigate through the complex long term care terrain to obtain quality healthcare.

title: Long Term Care Insurance: Information Frictions and Selection
abstract: We conduct a stated choice experiment where respondents are asked to rate various insurance products aimed to protect against financial risks associated with long term care needs. Using exogenous variation in prices from the survey design and individual cost estimates, these stated choice probabilities are used to predict market equilibrium for long term care insurance. We find that information frictions are pervasive. We measure the welfare losses associated with these three causes in a framework that also allows for selection. We show that information frictions reduce equilibrium take up and lead to large welfare loss while selection plays little role.

title: Displaced, disliked and misunderstood: A systematic review of the reasons for low uptake of long term care insurance and life annuities
abstract: textabstractWith aging populations, the role of private insurance in financing late in life risks is likely to grow. Yet, demand for long term care insurance (LTCI) and life annuities (hereafter annuities) is very limited and lags behind economic projections. This systematic literature review surveys the large number of theoretical and empirical studies analyzing this contradiction. We examine the LTCI and annuity puzzles separately and show which factors limit demand for insurance against both late in life risks. Our systematic search rendered 3,945 unique hits and findings of 187 studies were integrated in our analyses. Results hereof suggest that holding of both insurance products is systematically impeded by substitution by social security, adverse selection, nonstandard preferences and limited rationality due to low financial literacy and risk unawareness. Furthermore, insurance holding is concentrated among wealthier and subjectively healthier individuals. A comprehensive approach addressing all four reasons for low uptake may increase insurance holding most effectively and may particularly empower people with lower socio economic status to make well informed decisions.