Policy Proposals for the Efficiency of the Long-term Care Fund System Following the Transfer Missions of the Subdistrict Health Promotion Hospitals to the Provincial Administrative Organizations
Keywords:
Policy proposals, Long-term care fund system, Transfer missions of the subdistrict health promotion hospitalsAbstract
Background and Objectives The transfer of the missions of the subdistrict health promotion hospitals has led to structural changes that impact the operations of long-term care funds, both in terms of fund management and the provision of health care services to community recipients. This study aimed at developing policy proposals for the efficiency of the long-term care fund system following the transfer of the subdistrict health promotion hospitals.
Methods This was a mixed-methods research study in the research area of 747 funds across all transferred mission provinces. The research was conducted in three phases: Phase 1: Analyzing the situation and impact of the long-term care fund system operations following the transfer of the missions; Phase 2: Developing a model to enhance the efficiency of the long-term care fund system. Phase 3: Developing policy proposals for the efficiency of the long-term care fund system following the transfer of the missions.
Results Research findings revealed that 1) The majority of long-term care fund recipients were older adults, with an average age of 77.55 years, with 1.6% living in solitude. The average duration of dependency was 5.39 years, and they were diagnosed with hypertension (50.4%), followed by diabetes (26.8%). 2) The health services organized under the long-term care fund following the transfer of missions found that almost all caregivers were professional nurses who provided services in healthcare and organized long-term care in the community, leading to a heavy workload. In addition, it was found that almost all long-term care services lacked interdisciplinary teams joining for services. 3) The efficiency of the long-term care fund following the transfer of missions showed a statistically significant decrease in the fund's budget (p-value < .001) and a statistically significant decrease in the percentage of completed individualized care plans (p-value < .001).
Conclusion and Recommendations The crucial policy proposals for organizations involved with the long-term care fund following the transfer of missions include the development of a performance monitoring and evaluation system, enhancing the capabilities of care managers and caregivers, and developing long-term care standards to ensure patients can access services according to the integrated benefit package.
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