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长期护理的世界:经合组织国家的类型学。

Worlds of long-term care: A typology of OECD countries.

机构信息

University of Mannheim, Mannheim Centre for European Social Research, Germany A5, 6, 68159, Mannheim, Germany; University of Siegen, Department of Social Sciences, Adolf-Reichwein-Str. 2, 57068, Siegen, Germany.

University of Siegen, Department of Social Sciences, Adolf-Reichwein-Str. 2, 57068, Siegen, Germany.

出版信息

Health Policy. 2021 May;125(5):609-617. doi: 10.1016/j.healthpol.2021.02.009. Epub 2021 Feb 25.

Abstract

Providing long-term care (LTC) to the elderly is a major challenge for the welfare state. LTC systems differ widely among countries. Due to recent maturation, economization, and marketization processes, earlier LTC comparisons and typologies are no longer suitable to give a comprehensive overview of LTC systems and their major characteristics. In this paper we introduce a new typology of LTC systems in the OECD world, based on most recent OECD data and a unique set of institutional indicators. This typology aims to make LTC systems more comparable to welfare state and healthcare system typologies and thereby improve our understanding of how LTC is embedded in the wider welfare state and how it is related to other welfare state institutions. Based on 24 cluster analyses, we identify six (method-driven) and nine (content-driven) LTC types, which can be adapted in future studies according to the needs. In the six-types solution, we suggest a public supply type (e.g., Sweden), a private supply type (e.g., Germany), a residual public type (e.g., Poland), an evolving public supply type (e.g., Korea), a need-based supply type (e.g., Switzerland), and an evolving private need-based type (e.g., United States).

摘要

为老年人提供长期护理(LTC)是福利国家面临的重大挑战。国家之间的长期护理系统差异很大。由于最近的成熟、经济化和市场化进程,早期的长期护理比较和类型学不再适合全面概述长期护理系统及其主要特征。在本文中,我们根据经合组织的最新数据和一组独特的制度指标,介绍了经合组织国家的一种新的长期护理系统类型学。这种类型学旨在使长期护理系统更能与福利国家和医疗保健系统类型学相媲美,从而增进我们对长期护理如何融入更广泛的福利国家以及它与其他福利国家机构的关系的理解。基于 24 次聚类分析,我们确定了六种(方法驱动)和九种(内容驱动)长期护理类型,可根据需要在未来的研究中进行调整。在六种类型的解决方案中,我们建议采用公共供应类型(例如,瑞典)、私人供应类型(例如,德国)、剩余公共类型(例如,波兰)、不断发展的公共供应类型(例如,韩国)、基于需求的供应类型(例如,瑞士)和不断发展的基于私人需求的类型(例如,美国)。

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