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长期护理的未来成本:英国老年人长期护理的成本预测。

Future costs for long-term care: cost projections for long-term care for older people in the United Kingdom.

作者信息

Karlsson Martin, Mayhew Les, Plumb Robert, Rickayzen Ben

机构信息

Faculty of Actuarial Science and Statistics Cass Business School, City University, London, UK.

出版信息

Health Policy. 2006 Jan;75(2):187-213. doi: 10.1016/j.healthpol.2005.03.006. Epub 2005 Apr 22.

Abstract

The purpose of this paper is to analyse the future sustainability of the UK system for provision of long-term care (LTC) due to changes in demography and health status among the older people. It considers how demand for LTC will evolve and to what extent there will be sufficient supply to meet demand. For formal care, this requires an estimate of how much the public purses, and hence taxpayers, will be burdened with LTC costs. For informal care, it involves estimating whether there will be enough carers if current patterns of provision were to continue. The results show that demand for long-term care will start to take off 10 years from now, and reach a peak somewhere after 2040. The research finds that the most significant increase will be in demand for informal care, where the number of recipients are projected to increase from 2.2 million today to 3.0 million in 2050. Relative increases will be similar in all care settings, amounting to between 30 and 50% compared with the levels today; however, the most noticeable increase will be in demand for formal home care, which is projected to be 60% above current levels by 2040. Total expenditure on formal long-term care will increase from 11 billion pounds per year today to approximately 15 billion pounds per year by 2040 (in 2001 prices). Expressed in taxation terms the effective contribution rate will increase from around 1.0% of total wages today to 1.3% in 2050. Availability of informal carers is potentially a big problem, but the extent of the problem is very sensitive to the assumptions made concerning health improvements and care-giving patterns.

摘要

本文旨在分析由于老年人口的人口结构和健康状况变化,英国长期护理(LTC)体系未来的可持续性。它考量了长期护理需求将如何演变,以及在何种程度上会有足够的供给来满足需求。对于正规护理而言,这需要估算公共财政以及纳税人将承担多少长期护理成本。对于非正规护理来说,则涉及到如果维持当前的供给模式,是否会有足够的护理人员。结果显示,长期护理需求将从现在起10年后开始迅速增长,并在2040年之后的某个时间达到峰值。研究发现,增长最为显著的将是非正规护理需求,预计接受非正规护理的人数将从如今的220万增加到2050年的300万。所有护理领域的相对增幅都将类似,与当前水平相比增长30%至50%;然而,增长最为明显的将是正规家庭护理需求,预计到2040年将比当前水平高出60%。正规长期护理的总支出将从如今每年110亿英镑增加到2040年的约150亿英镑(按2001年价格计算)。以税收来表示,有效贡献率将从当前占总工资的约1.0%增加到2050年的1.3%。非正规护理人员的可获得性可能是一个大问题,但该问题的严重程度对有关健康改善和护理模式的假设非常敏感。

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