long-term care policy making

Summarize principles that should guide long-term care policy making.

The purpose of this paper is to summarize the key findings from a series of papers published in Health Affairs on how best to design and implement policies for improving access, quality, efficiency, equity, and cost containment in U.S. nursing homes. This article summarizes the main points made by each author about what we know now and where there are gaps in our knowledge. It also provides an overview of some of the major issues facing policymakers as they consider ways to improve NH care.

Methods: We reviewed all articles published between January 1, 2000, and December 31, 2005, in Health Affairs that were related to health services research or public policy analysis. Articles were selected based on their relevance to one or more of four broad categories: access; quality; efficiency; and equity. Each category was further divided into subcategories. For example, under “access,” we identified three subcategories: admission processes, discharge planning, and postacute care transitions. Under “quality” we included five subcategories: staffing levels, resident outcomes, facility characteristics, organizational culture, and regulatory oversight. Finally, under “cost containment,” we identified two subcategories: payment methods and provider incentives. In addition, we conducted extensive searches using PubMed and Google Scholar to identify additional relevant literature not found through the initial search strategy.

Results: A total of 24 articles met inclusion criteria.

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