From fragmentation toward integration: A preliminary study of a new long-term care policy in a fast-aging country

Tzu Ying Chiu, Hsiao Wei Yu, Rei Goto, Wen Lin Lai, Hsi Chang Li, En Tien Tsai, Ya Mei Chen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Taiwan, one of the fastest-aging countries in the world, started implementing version 1.0 of its long-term care (LTC) plan in 2008. In 2017, LTC Plan 2.0 began a new era with its goal to integrate Taiwan's fragmented LTC service system. LTC Plan 2.0 also aims to establish an integrated community-based LTC system incorporating both health care and disability prevention. This three-tier model consists of the following: two LTC services with a day-care center as their base and case management (Tier A), a day-care center and a single LTC service (Tier B), and LTC stations that provide primary prevention services and respite services for frail community-dwelling older adults to prevent further disabilities (Tier C). A defined cluster of agencies in a local area works together as a Tier ABC team. LTC Plan 2.0 is a new policy for Taiwan, and hence it is important to understand the agencies' initial difficulties with implementation and identify future challenges to help further policy development. Methods: This preliminary study explored the challenges to implementing LTC 2.0 through in-depth interviews based on Evashwick's integration mechanisms with representatives from three service teams. We interviewed three chief executive officers and three case managers. Results: We found that the LTC Plan 2.0 mechanisms for service integration have been insufficiently implemented. Recommendations include (1) Build up the trust between agencies and government, avoid duplication of LTC services within Tier ABC team, and encourage agencies within a team to create a shared administrative system with the same mission and vision. (2) Clarify the roles and responsibilities of government care managers and agency case managers. (3) Provide an integrated information system and create an official platform for sharing client records across different agencies and caregivers. (4) Establish a tool and platform to track the budget and payment across different levels of service as soon as possible. Conclusion: There is an increased demand for LTC services in Taiwan because of its rapidly aging population. Our findings shed some light on the challenges to developing integrated LTC services and thus may help both policymakers and service providers find ways to overcome these challenges.

Original languageEnglish
Article number159
JournalBMC Geriatrics
Volume19
Issue number1
DOIs
Publication statusPublished - 2019 Jun 7

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Long-Term Care
Taiwan
Independent Living
Government Agencies
Policy Making
Case Management
Budgets
Primary Prevention
Information Systems
Caregivers

Keywords

  • Integration mechanisms
  • Long-term care (LTC) plan 2.0
  • Tier ABC team

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

From fragmentation toward integration : A preliminary study of a new long-term care policy in a fast-aging country. / Chiu, Tzu Ying; Yu, Hsiao Wei; Goto, Rei; Lai, Wen Lin; Li, Hsi Chang; Tsai, En Tien; Chen, Ya Mei.

In: BMC Geriatrics, Vol. 19, No. 1, 159, 07.06.2019.

Research output: Contribution to journalArticle

Chiu, Tzu Ying ; Yu, Hsiao Wei ; Goto, Rei ; Lai, Wen Lin ; Li, Hsi Chang ; Tsai, En Tien ; Chen, Ya Mei. / From fragmentation toward integration : A preliminary study of a new long-term care policy in a fast-aging country. In: BMC Geriatrics. 2019 ; Vol. 19, No. 1.
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