Containing use and expenditures in publicly insured long-term care programs.
British Columbia and Manitoba have the most developed and comprehensive publicly financed long-term care (LTC) programs in North America. For U.S. policymakers, these programs are large-scale natural experiments with public LTC insurance. During the 1980s, both provinces successfully contained the growth of public expenditures on nursing homes, and one province successfully contained the growth of public expenditures on home support services, adjusting for population growth. Because provincial cost-control methods are similar to those that some States already use, it is likely that managers could contain the growth of public expenditures once a publicly insured U.S. LTC program was implemented. The level of public expenditure would depend partly on the level of compensation for LTC sector personnel, which is relatively low in the United States.
Institute for Health and Aging, University of California, San Francisco 94143.
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Miller
D000368:Aged; D001955:British Columbia; D003363:Cost Control / Q000379:methods; D003625:Data Collection; D005102:Health Expenditures / Q000706:statistics & numerical data; D006699:Home Care Services / Q000191:economics* / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007353:Insurance, Long-Term Care / Q000191:economics* / Q000706:statistics & numerical data; D008350:Manitoba; D009313:National Health Programs / Q000191:economics*; D009735:Nursing Homes / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data