Structure and Organizing of Home-Based Care for Older Adults in Different Countries: Scoping Review

Abstract

Background Demographic changes, growing long-term living costs, personal preferences, and policies encouraging aging in place have increased the importance of home-based long term care (LTC). It seems that sharing the experiences of leading countries will help to provide effective system. As a result, this review aims to explain the structure of home-based LTC for older adults in different countries. Methods A scoping review was performed for literature on home-based care for older adults published in English, using PubMed, Embase, Scopus, Web of sciences, CINAHL and Google Scholar databases and other sources of information to identify grey literature. We classified the acquired data in the domains of Governing; LTC, eligibility and financing; Benefits; marketization and free choice system; Workforce training, and Quality assurance of care. This scoping review was performed in accordance with the PRISMA Extension for Scoping Reviews. Results Overall, 44 documents out of 4072 studies were included in the final analysis, which contained related to data from 23 countries. Each study covers some domains of home care (HC), and some other studies are linked to comparing these domains in some Asian and European countries. Among Asian countries, Japan and South Korea were pioneers in HC. Limited studies were found on workforce training and HC structure changes during the COVID-19 pandemic. Other components of HC were frequently discussed in all countries. The regulation makes authorities organize high-quality care. Central government and ministries set the legal framework, and municipalities are autonomous in determining kind of strategies, and the principles of providing HC services and financing. Older adults are usually eligible to receive services based on their level of need or assets. Cash and in-kind benefits are given to older adults, depending on their choice. Financing is also done using insurance, taxes, or privately. Some countries have made training caregivers and quality assessment of services mandatory, but some countries do not have specific guidelines. Conclusion The results of this study can guide policymakers in designing an organized home care system to increase the quality of services and satisfaction level of the beneficiaries while simultaneously reducing the health system's costs.

Experiences regarding Home Care for Older Adults from the Viewpoint of Family, Paid Caregivers, Nurses, and Experts: A Qualitative Study

“…Similar to the results of this study, universal coverage of long-term care insurance can solve the needs of older adults with chronic conditions in the community [75]. According to various pieces of literature, quality care should cover dimensions such as a competent workforce, patient satisfaction, person-centered care, patient involvement in decision-making, and compliance with care standards [76,77]. In leading countries in HC, such as Germany and Japan, issues such as long-term care insurance, benefts, rights, and ethics in care are among the passed laws [78,79].…”

Prevalence of Refractive Errors and Associated Factors in the Population of the Eye Cohort Study in Southeast Iran

“…As age increases, it is expected that the former decreases and the latter increases, which confirms our results. Furthermore, other studies have confirmed that the occurrence of against-the-rule astigmatism increases with age, possibly due to the relaxation of eyelid muscles and reduced eyelid pressure (40)(41)(42).…”