The long-term care system: Quality and Access

The long-term care system: Quality and Access

Introduction

Long term care system refers to a multifaceted set of services, which established in a very short period of time. In several ways, research in the sector of health services has been the major contributing factor in the field. The significant growth of a substitute to the institutional care consists of home-bases and community-based care. These growths of alternatives were highlighted from various demonstration projects, like the National Long-Term Care Demonstration, which were supported by the federal government. Furthermore, the measures of Activities of daily living (ADL) that came into existence from Sidney Katz's research, which facilitated in evolving thinking about treatment of recipients in this particular system. However, through the continuance growth and alteration system of the long term care setting, many new challenges arise at all levels. Furthermore, it provided ample of opportunities to have new research to be conducted, as well as, to implement the existing research application in innovative ways. Shortages of workforce, measuring and delivering of quality care, inadequacy of integrative care and unstable financing are some of the challenges faced by the long term care system (Raphael, 2003).

These challenges are expected to aggravate with the aging population. Hence, more research is essential at this critical point. The generation Baby Boom has begun to retire since year 2010, continuously rising number of the population that is more than 85 years of age people requiring more long term care. It is further anticipated doubling by the year 2010 (Raphael, 2003). This paper evaluates the long term care system. It also aims, in particular, on the quality and access of long term care to the overall population.

Discussion

Over the last decade, the initiatives for the quality assurance in the long term care aims at regulatory programs, including strengthening the survey and certification process for the providers. On the contrary, few efforts have been made on the reimbursement's role to promote or inhibit the quality of long term care system. The inadequate amount of stress contributed to the inadequate data until the report of 1986 Institute of Medicine (IOM) on nursing homes. Numerous studies associated the poor quality seen in nursing homes to low rates of Medicaid payments. Even though, there is not much information available about the effects of reimbursements on the care of quality provided in nursing homes, the information regarding the impact on the services on home-based or community-based is almost not available (Improving the Quality of Long-Term Care, 2001, pp. 235-236).

Recently, two developments highlighted the association between quality offered at the long term care and the reimbursement. In included the federal Balanced Budget Act of 1997, which revoked the federal standards of reimbursing the nursing home care under the Medicaid program. As a result, this gave the states unlimited freedom to set the payment rates of nursing homes. In contrast, the Medicaid home and community-based settings always had this complete freedom. Secondly, the Balanced Budget Act of 1997 significantly changes methods ...