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Table 1. Framework for Long-Term Care (LTC) Research Priorities
Comparing cost and benefits of alternatives.
- Approaches to care (e.g., primary care, rehabilitation, prescription drugs) within settings and service types.
- Special care units.
- Identifying best practices and distribution by payment.
- Staffing issues (e.g., mix,training, communication).
- Ownership (e.g., for-profit/nonprofit, chain/or not, increasing vertical integration).
- Impact of amenities and
home environment (on
quality of life).
- Monitoring the distribution of LTC expenditures across payment sources Medicare, Medicaid, private pay).
- Measuring financial burden (e.g., LTC insurance, out-of-pocket costs) relative to income and assets.
- Assessing the impact of growth in assisted living on financial burden source.
Financial and Market Incentives
- Studies of impact of the level and type (prospective vs. retrospective, flat vs.
cost-based) of reimbursement on:
- Patient mix.
- Impact of prospective payment on quality and cost.
- Understanding the impact of increasing market competition on health outcomes.
- Understanding barriers to diffusion of new technology.
- Improving quality information to consumers (e.g., quality report cards).
- Understanding factors affecting consumers' choice of setting and care.
- Understanding consumers' willingness to pay for higher quality.
- Designing facilities to match housing and LTC needs.
- Using outcomes to target facilities.
- Developing ways to monitor quality of life.
- Developing ways to assess the quality of the long-term care system as a whole.
- Characterizing processes of care.
- Characterizing changing facility structures.
- Outcome measurement.
- Quality of life.
- Risk adjustment.
- Matching outcome measures to types of care/setting.
- Measuring patient preferences.
- Measuring private prices and reimbursement.
- Assessing consumer preferences and satisfaction.
- Feasibility of linking MDS data to survey data.
- Strategies for screening person at high risk of long-term care use.
- Development of a broad residential care frame.
- Projecting future LTC service needs, demographics, and disabilities.
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