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Equity, efficiency, and financial risk of alternative arrangements for funding long-term care systems in an ageing society

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  • José-Luis Fernández
  • Julien Forder

Abstract

Partly a reflection of the increasing volume and hence political influence of the older population, recent reforms of long-term care (LTC) systems across developed countries have sought to expand the coverage of the services provided, and have defined increasingly universal levels of state support for people with social-care needs. At the same time, some of the factors leading to the expansion of the objectives and ambitions of the care system, such as the ageing of the population, pose significant challenges to its long-term financial sustainability. In this context, the paper first reviews the main factors likely to contribute to the growth in LTC demand and expenditure, and reflects on the policy priorities associated with state-backed funding systems in the area. Using results from a bespoke dynamic micro-simulation model, it then illustrates the discussion through a quantitative analysis of the equity and efficiency implications of alternative funding models discussed in the context of the ongoing reforms of the LTC system in England. Copyright 2010, Oxford University Press.

Suggested Citation

  • José-Luis Fernández & Julien Forder, 2010. "Equity, efficiency, and financial risk of alternative arrangements for funding long-term care systems in an ageing society," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 26(4), pages 713-733, Winter.
  • Handle: RePEc:oup:oxford:v:26:y:2010:i:4:p:713-733
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    File URL: http://hdl.handle.net/10.1093/oxrep/grq036
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    Cited by:

    1. David Lim & Ashley Grady & Karen P. Y. Liu, 2023. "Public Mixed Funding for Residential Aged Care Facilities Residents’ Needs in the Asia–Pacific Region: A Scoping Review," IJERPH, MDPI, vol. 20(21), pages 1-10, November.
    2. Halásková Renáta & Bednář Pavel & Halásková Martina, 2017. "Forms of Providing and Financing Long-Term Care in OECD Countries," Review of Economic Perspectives, Sciendo, vol. 17(2), pages 159-178, June.
    3. Helen Weatherly & Rita Faria & Bernard Van den Berg & Mark Sculpher & Peter O’Neill & Kay Nolan & Julie Glanville & Jaana Isojarvi & Erin Baragula & Mary Edwards, 2017. "Scoping review on social care economic evaluation methods," Working Papers 150cherp, Centre for Health Economics, University of York.
    4. Wei Yang & Julien Forder & Olena Nizalova, 2017. "Measuring the productivity of residential long-term care in England: methods for quality adjustment and regional comparison," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(5), pages 635-647, June.
    5. repec:bla:glopol:v:8:y:2017:i:s2:p:7-22 is not listed on IDEAS
    6. Panos Kanavos & Olivier Wouters & Aris Angelis & David Tordrup & Panos Kanavos, 2017. "Is the Funding of Public National Health Systems Sustainable over the Long Term? Evidence from Eight OECD Countries," Global Policy, London School of Economics and Political Science, vol. 8, pages 7-22, March.

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