Health status, care needs, and assessment for beneficiaries with or without dementia in a public long-term care insuranc
- PDF / 955,562 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 64 Downloads / 183 Views
RESEARCH ARTICLE
Open Access
Health status, care needs, and assessment for beneficiaries with or without dementia in a public long-term care insurance pilot in Guangzhou, China Jialan Wu1,2, Siman Chen1,2, Huangliang Wen1,2, Yayan Yi1,2 and Xiaoyan Liao1*
Abstract Background: Chinese government launched a pilot study on public long-term care insurance (LTCI) recently. Guangzhou is one of the fifteen pilot cities, officially started providing LTCI in August 2017. An in-depth analysis of experimental data from the pilot city may provide suggestions for developing a fair and effective LTCI system. This study aimed to evaluate the LTCI pilot by exploring the characteristics and care needs of claimants, and performance of the assessment tool. Methods: A retrospective cross-sectional study in which claims data between July 2018 and March 2019 in the Guangzhou pilot was analyzed. LTCI claimants during the study period were included. The care needs were determined based on claimants’ physical function assessed by the Barthel Index and their medical conditions. Rasch analysis was used to explore the performance of the Barthel Index. Results: Among 4810 claimants included, 4582 (95.3%) obtained LTCI benefits. Of these beneficiaries, 4357 (95.1%) were ≧ 60 years old, and 791 (17.3%) had dementia. Among 228 (4.7%) unsuccessful claimants, 22 (0.5%) had dementia. The prevalence of stroke was high in beneficiaries with (38.1%) or without dementia (56.6%), as well as in unsuccessful claimants with (40.9%) or without dementia (52.4%). Beneficiaries without dementia needed more support for basic activities of daily living and nursing care than those with dementia, while beneficiaries with dementia were more likely to be institutionalized. Five (22.7%) unsuccessful claimants with dementia and 48 (23.3%) unsuccessful claimants without dementia were disabled in at least two basic self-care activities. Regarding Barthel Index, Rasch analysis showed threshold disordering in “mobility” and “climbing stairs”, and the narrow interval was observed between all the adjacent categories of the ten items (< 1.4 logits). Conclusions: Stroke and dementia were two common reasons for needing long-term care in LTCI claimants. The Barthel Index is not suitable for assessing and dividing LTCI claimants, because of inappropriate items and narrow category responses. A comprehensive assessment and grading system is required, together with needs-led care services. The eligibility should be expanded gradually based on balance finance solutions. Keywords: Barthel index, Dementia, Eligibility, Long-term care insurance, Rasch analysis
* Correspondence: [email protected] 1 Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, No. 28 Innovation Avenue, Zengcheng, Guangzhou 511300, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribut
Data Loading...
