6. Means and Resources

This theme addresses crucial aspects of funding (including funding mechanisms and budgeting) and human resources in LTC as well as IT and other technical support mechanisms. Because LTC expenditures are set to rise over the coming decades, it will be of utmost importance to use resources as effectively and efficiently as possible – designing shared funding mechanisms and allocating financial and human resources will thus be key issues to guarantee support for people with LTC needs.

6.1 (Shared) Funding

This sub-theme is about funding and funding mechanisms explicitly designed for LTC services, facilities and financial support schemes. Examples should be provided for all countries as this will be important background information for other themes and sub-themes, in particular if reforms have focused on incentives to pool social and health care funding. Examples include at least one of the following key issues:

  1. Types of funding (insurance-based vs. tax-based)
  2. Financial incentives between different levels of funding (national vs. regional or local; health vs. social; formal vs. informal levels; the role of insurance companies/agencies)
  3. Commissioning and contracting with individual or pooled budgets

 

6.2 Enabling, allocating and funding human resources

This sub-theme should highlight means and mechanisms to educate and train professional staff for LTC services, but also to allocate and retain staff in this sector. What are the successful mechanisms to select and retain staff in LTC services? Which role does the level of payment play in retention policies at the organisational level? Examples must include at least one of the following key issues:

  1. Recruiting models (including ethical international recruitment)
  2. Levels of payment of staff in LTC
  3. (New) job profiles in LTC
  4. Innovative education or career patterns

6.3 Supporting informal carers as a resource for LTC

This sub-theme will underpin the need for specific support for informal carers who are and will remain the most important resource for people in need of LTC. This should not only include examples that describe financial off-set against professional expenditure, but also those that describe financial or other benefits to informal carers. Examples include at least one of the following key issues:

  1. Financial support schemes for informal carers and their funding
  2. Funding of services, training and other in-kind support directed at informal carers
  3. Funding of initiatives to reconcile work and caring

 

6.4 Financial Indicators

The lack of data on tangible financial indicators of LTC at the organisational and systems level has been criticised in all relevant studies over the past decades. Still, basic indications on an organisational and/or systems level are available and examples should be presented with a view to trends and tendencies so that debates may be based on additional evidence and national practice can be assessed using contextual evidence. Most of these indicators do exist and will be exhibited in comparative tables. Examples include the following key issues:

  1. Expenditures for LTC as a percentage of GDP
  2. Percentage of population with LTC needs in residential care as opposed to home care
  3. Percentage of population with LTC needs using community care services
  4. Number of staff working in LTC (as a percentage of total workforce)
  5. Percentage of funding by stakeholders (public, private out-of-pocket, other)

 

6.5 Outcome indicators

We are looking for examples that are on the pathway to developing and assessing outcomes or at least results-oriented indicators at an organisational or even a systems level. Which results-oriented indicators are used to show effectiveness of LTC services? Examples include at least one of the following key issues:

  1. Initiatives that strive to develop and implement outcome indicators
  2. Costs of different services in relation to number of users
  3. Methods and indicators used to measure quality of service

 

6.6 Role of information technology

Information technology (IT) has played an important role in the development of health care over the past few decades. This includes technology in surgery and other applications as well as administrative and management applications (E-health). With some delay, social care and LTC services have also started to implement IT solutions in organising services and in improving housing environments – from mobile phones with care management applications to ‘smart homes’. What is included in IT solutions for overcoming blockages and problems at the interfaces between health and social care organisations? Examples include at least one of the following key issues:

  1. IT solutions in ambient assisted living and smart housing
  2. IT solutions in LTC management
  3. IT applications at the interfaces between health and social care professionals
  4. IT applications at the interfaces between health and social care administrations
  5. IT applications at the interfaces between formal and informal care