Reforming the funding of long-term care for older people: costs and distributional impacts of planned changes in England.

IF 3 3区 医学 Q2 HEALTH POLICY & SERVICES
Bo Hu, Ruth Hancock, Raphael Wittenberg, Derek King, Marcello Morciano
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Abstract

Reforms to the means tests in England for state-financed long-term care were planned for implementation in 2025. They included a lifetime limit (cap) on how much an individual must contribute to their care, with the state meeting subsequent care costs. We present projections of the costs and distributional impacts of these reforms for older people, using two linked simulation models which draw on a wide range of data. We project that by 2038 public spending on long-term care for older people in England would be about 14% higher than without the reforms. While the main direct beneficiaries of the lifetime cap would have been the better off who currently receive no state help with their care costs, the reforms also treated capital assets more generously than the current system, helping people with more modest incomes and wealth. When analysing the impacts of the reforms it is therefore important to consider the whole reform package. Our results depend on a range of assumptions, and the impacts of the reforms would be sensitive to the levels of the cap and other reformed parameters of the means test on implementation.

改革老年人长期护理的资金:英格兰计划变化的成本和分配影响。
英国计划在2025年实施针对国家资助的长期护理的经济状况调查改革。其中包括对个人必须支付多少护理费用的终身限制(上限),随后的护理费用由国家支付。我们使用两个关联的模拟模型,利用广泛的数据,对这些改革对老年人的成本和分配影响进行了预测。我们预计,到2038年,英国用于老年人长期护理的公共支出将比没有改革时高出14%左右。虽然终身上限的主要直接受益者将是那些目前在医疗费用方面没有得到国家帮助的富人,但改革对资本资产的处理也比现行制度更为慷慨,帮助了收入和财富较低的人。因此,在分析改革的影响时,必须考虑整个一揽子改革方案。我们的结果取决于一系列假设,而改革的影响会对实施时的上限和其他改革后的入息调查参数的水平很敏感。
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来源期刊
Health Economics Policy and Law
Health Economics Policy and Law HEALTH POLICY & SERVICES-
CiteScore
5.30
自引率
0.00%
发文量
55
期刊介绍: International trends highlight the confluence of economics, politics and legal considerations in the health policy process. Health Economics, Policy and Law serves as a forum for scholarship on health policy issues from these perspectives, and is of use to academics, policy makers and health care managers and professionals. HEPL is international in scope, publishes both theoretical and applied work, and contains articles on all aspects of health policy. Considerable emphasis is placed on rigorous conceptual development and analysis, and on the presentation of empirical evidence that is relevant to the policy process.
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