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Healthcare
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Quality Integrated Long-Term Care for Older People
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Quality Integrated Long-Term Care for Older People

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Community Care".

Deadline for manuscript submissions: closed (30 April 2025) | Viewed by 1531

Special Issue Editor

Dr. Tomoko Kodama

E-Mail Website
Guest Editor
Department of Public Health Policy, National Institute of Public Health, Saitama 351-0197, Japan
Interests: quality of Long-term care; health service research; healthcare quality indicators; healthy aging; integrated care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Population ageing is a challenge that the world is currently facing, and thus, expanding access to and continuity of long-term care services has become a common international concern.

In recent years, the increase in chronic diseases, such as non-communicable diseases, has also increased the need for long-term care, so the provision of quality long-term care for older people is an issue that needs to be addressed. We need to consider quality assessment of long-term care, including the use of multiple services, home-based care, the presence of informal care, community involvement, person-centered decision-making and integration of all relevant services.

Long-term care depends on national policies, including social security, and on the economic, social and cultural contexts. There is a need for continuous and seamless long-term care systems, complementing home and community-based services with residential (institutional) care options, integration with health and social care services and primary care, and improved person-centered skills for complex care such as advanced dementia. It is also expected to be accelerated by improving digital literacy and the use of technology (development of assistive devices and techniques) and ICT to maintain independence.

This Special Issue seeks contributions on a range of findings related to LTC resources and access, quality of life of users and carers, integration between different services, dementia care, and ICT use, in order to increase our knowledge and evidence on quality integrated LTC.

We hope that the manuscripts submitted to this Special Issue, addressing LTC for older people from different countries, will contribute to improving quality LTC for older people.

I look forward to receiving your contributions.

Dr. Tomoko Kodama
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • integrated care
  • long-term care
  • older people
  • person-centered care
  • quality of life
  • caregivers
  • care for the people with dementia
  • information and communication technology

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Published Papers (3 papers)

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Research

11 pages, 279 KiB  
Article
The Impact of Long-Term Care Insurance for Older Adults: Evidence of Crowding-In Effects
by Hyeri Shin
Healthcare 2025, 13(12), 1357; https://doi.org/10.3390/healthcare13121357 - 6 Jun 2025
Viewed by 76
Abstract
Objectives: This study investigates the presence of crowding-in or crowding-out effects of long-term care insurance (LTCI) on older adults’ care in Korea. Additionally, it examines the influence of old-age income security and private systems, including private transfer income and private health insurance, on [...] Read more.
Objectives: This study investigates the presence of crowding-in or crowding-out effects of long-term care insurance (LTCI) on older adults’ care in Korea. Additionally, it examines the influence of old-age income security and private systems, including private transfer income and private health insurance, on these effects. The analysis focuses on three aspects: family-provided care, private non-family care, and total care expenses. Methods: This study conducted logistic and linear regression. Logistic regression was used to examine the likelihood of receiving family-provided and private non-family care, while linear regression analyzed factors associated with total care expenditures. Results: The results reveal a crowding-in effect for family care, as greater utilization of public LTCI is positively associated with family-provided care. However, the relationship between public LTCI and private non-family care was not statistically significant, suggesting that the crowding-in effect on private care systems remains limited. Lastly, LTCI utilization was significantly associated with higher care expenditures. It is noteworthy that the current public LTCI in Korea has low coverage, resulting in insufficient care provision. Consequently, there is growing activity in the private care sector. Conclusions: These findings highlight the need for a more integrated approach to long-term care in Korea, balancing public, private, and family care resources. To achieve quality integrated long-term care for older people, policymakers should focus on expanding public LTCI coverage while fostering coordination between family caregivers and professional care services, ensuring a comprehensive and high-quality care system that meets the diverse needs of Korea’s aging population. Full article
(This article belongs to the Special Issue Quality Integrated Long-Term Care for Older People)
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26 pages, 1743 KiB  
Article
Effectiveness of New Reactivation Approaches in Integrated Long-Term Care—Contribution to the Long-Term Care Act
by Suzanna Mežnarec-Novosel, Marija Bogataj, David Bogataj and Eneja Drobež
Healthcare 2025, 13(10), 1187; https://doi.org/10.3390/healthcare13101187 - 19 May 2025
Viewed by 409
Abstract
Objectives: This study evaluates the effectiveness of an innovative, integrated healthcare approach based on the “Long-term Care (LTC) in the Community” pilot project, aimed at testing solutions for the new LTC Act and associated regulations in Slovenia. It is based on a small [...] Read more.
Objectives: This study evaluates the effectiveness of an innovative, integrated healthcare approach based on the “Long-term Care (LTC) in the Community” pilot project, aimed at testing solutions for the new LTC Act and associated regulations in Slovenia. It is based on a small sample, which can be financed from European project funds. This methodology is crucial for the subordinate legislation derived from the LTC Act. Methods: We selected beneficiaries who decided to receive integrated services in their home environment in rural areas. Among 132 beneficiaries who received various care services at home, 75 beneficiaries received integrated services to maintain independence, while a control group of 57 persons did not receive these despite eligibility. The hypothesis that the new reactivation and other services to strengthen and maintain independence facilitate a transition to a lower category of LTC within the system of different states of abilities and that new approaches with integrated home care are much more successful were tested using the Z + 4 test. Results: Seven out of eight users’ abilities were improved by an inventive approach to LTC at home, including reactivation activities, with p < 0.025. The probability that the new methods will outperform the old ones for an arbitrarily selected senior eligible for LTC exceeded 0.89. Thus, we used quantitative methods to confirm the reasonableness of the decisions included in the LTC Act and will help to estimate savings in the health fund. Conclusions: These positive results promote the implementation of integrated care strategies, norms, and standards, which will be further articulated in subordinate legislation. Full article
(This article belongs to the Special Issue Quality Integrated Long-Term Care for Older People)
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10 pages, 194 KiB  
Article
The Act on Integrated Support for Community Care Including Medical and Nursing Services: Implications for the Role of Tertiary Hospitals in the Republic of Korea
by Byeungtae Park, Pyeong-Man Kim, Chul-Min Kim, Chang-Jin Choi and Hyun-Young Shin
Healthcare 2025, 13(10), 1156; https://doi.org/10.3390/healthcare13101156 - 15 May 2025
Viewed by 375
Abstract
Background/Objectives: The Republic of Korea is undergoing a significant demographic shift toward a population with a high proportion of older adults. In response, the Act on Integrated Support for Community Care was enacted. This study explores the role of tertiary hospitals in integrated [...] Read more.
Background/Objectives: The Republic of Korea is undergoing a significant demographic shift toward a population with a high proportion of older adults. In response, the Act on Integrated Support for Community Care was enacted. This study explores the role of tertiary hospitals in integrated care, aiming to enhance healthcare systems that support older individuals by facilitating the transition from hospital- to community-based care. Methods: Seoul St. Mary’s Hospital, operating under the Catholic Foundation, provides care grounded in healing and spirituality. As part of its mission, a multidisciplinary task force (TF) was formed to examine the hospital’s role in integrated care for an aging society. The TF, composed of eight experts from various departments, engaged in open discussions from September 2024 to January 2025. Results: The Integrated Care Act, which seeks to integrate medical care and caregiving within communities, requires the development of a digital system, the establishment of a governance framework for multidisciplinary collaboration, and the creation of institutions for training professionals in integrated care. Tertiary hospitals must develop department-specific models for transitional care and establish policy research institutes focused on holistic, patient-centered care. Family medicine departments can play a central role in coordinating between tertiary hospitals and local communities. Conclusions: This study highlights the importance of collaboration between medical, caregiving, and social welfare professionals as key enablers of “aging in place”. The findings underscore the evolving role of tertiary hospitals and contribute to fostering a more sustainable healthcare model for Korea’s aging population. Full article
(This article belongs to the Special Issue Quality Integrated Long-Term Care for Older People)
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