Key policy issues in long-term care (LTC) are complex and the numbers of persons needing such care continue to incease. This volume addresses these issues: the role of and support to the family; integration with health and social systems; case management; and strategies for designing LTC systems.
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
This volume is unique in its systematic approach to these three pillars of health systems analysis will give readers of various backgrounds authoritative material about subjects adjacent to their own specialties. Assembling such comparative materials is usually an onerous task because so many programs possess their own vocabularies, goals, and methods. This book will provide common grounds for people in programs as diverse as economics and finance, allied health, business and management, and the social sciences, including psychology. - Gives readers of various backgrounds authoritative material about subjects adjacent to their own specialties - Provides common grounds for people in programs as diverse as economics and finance, allied health, business and management, and the social sciences, including psychology
Long-term care can be vexing on a personal as well as social level, and it will only grow more so as individuals continue to live longer and the population of aged persons increases in the United States and around the world. This volume explores the ethical issues surrounding elder care from an ecological perspective to propose a new theory of global justice for long-term care. Care work is organized not just nationally, as much current debate suggests, but also transnationally, through economic, labor, immigration, and health policies established by governments, international lending bodies, and for-profit entities. Taking an epistemological approach termed “ecological knowing,” Lisa A. Eckenwiler examines this organizational structure to show how it creates and sustains injustice against the dependent elderly and those who care for them, including a growing number of migrant care workers, and how it weakens the capacities of so-called source countries and their health care systems. By focusing on the fact that a range of policies, people, and places are interrelated and mutually dependent, Eckenwiler is able not only to provide a holistic understanding of the way long-term care works to generate injustice but also to find ethical and practicable policy solutions for caring for aging populations in the United States and in less well-off parts of the world. Deeply considered and empirically informed, this examination of the troubles in transnational long-term care is the first to probe the issue from a perspective that reckons with the interdependence of policies, people, and places, and the first to recommend ways policymakers, planners, and families can together develop cohesive, coherent long-term care policies around the ideal of justice.
The new welfare settlement in Europe involves a re-direction of policy in the context of a unified market and currency system and of more stringent economic competition. Realignment of the policy assumptions and goals of the key actors is central to this process. This book reviews the main policy paradigms and analyzes the processes whereby they have changed in the most salient policy areas, and is based on recent interviews with more than two hundred and fifty senior policy actors in seven West European countries.