Comparative Barriers and Enablers in ASEAN Long-Term Care Systems: Insights From the 2025 Regional Policy Dialogue and Policy Recommendations for Equitable Active Ageing

IF 1.8 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing Pub Date : 2026-10-01 DOI:10.1111/ajag.70237

Ruttiya Bhula-or, Chadatan Osatis, Orawan Prasitsiriphon, Man Thi Hue Vo, I-Chun Chen

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引用次数: 0

Abstract

Objective

To examine barriers and enablers to equitable long-term care (LTC) across ASEAN-Plus Three (APT) economies and to propose a framework for equitable active ageing, contributing to Sustainable Development Goals 3 and 10.

Methods

A qualitative participatory-observation study was conducted during the 2025 Regional Policy Dialogue on Inclusive and Equitable Care Systems. Reflexive thematic analysis, read through a life-course lens, was applied to three deliberation sessions involving 107 stakeholders from policy, academic, civil-society and provider sectors across diverse welfare regimes.

Results

Three themes were generated: institutional fragmentation converts earlier disadvantage into unequal access; communities absorb shortfalls in formal care without displacing public responsibility; and equity depends on redistributing voice and coordinating responsibility across levels. Costs fall heaviest on women and on rural and low-income older people.

Conclusions

A critical participatory life-course framework can guide LTC redesign through inclusive governance; national coordination hubs are advanced as an author-generated proposal extending participants' calls for coordination.

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东盟长期护理系统的比较障碍和推动者：来自2025年区域政策对话和公平积极老龄化政策建议的见解

研究东盟与中日韩（10 + 3）经济体公平长期护理（LTC）的障碍和推动因素，并提出公平积极老龄化的框架，为可持续发展目标3和10做出贡献。方法在2025年包容性和公平护理系统区域政策对话期间进行定性参与性观察研究。通过生命历程视角解读的反思性专题分析被应用于三次审议会议，涉及来自不同福利制度的政策、学术、民间社会和提供部门的107名利益攸关方。结果产生了三个主题：制度碎片化将早期的劣势转化为不平等的机会；社区在不取代公共责任的情况下吸收正规护理方面的不足；而公平取决于话语权的重新分配和跨层级责任的协调。妇女、农村和低收入老年人的负担最重。关键的参与式生命历程框架可以通过包容性治理指导LTC的重新设计；国家协调中心作为作者提出的提案，扩展了参与者对协调的呼吁。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australasian Journal on Ageing 医学-老年医学

CiteScore

3.10

自引率

6.20%

发文量

114

审稿时长

>12 weeks

期刊介绍： Australasian Journal on Ageing is a peer reviewed journal, which publishes original work in any area of gerontology and geriatric medicine. It welcomes international submissions, particularly from authors in the Asia Pacific region.