Chapter 19
Into the Future:Trends To Watch
Learning Objectives
Understand the forces that have brought the long-term care system to its current state
Identify ways in which the challenges have been met and to what degree
Identify challenges that have not been met
Learning Objectives (continued)
4.Identify changes that have been brought on by the solutions to earlier challenges
5.Identify the trends that will affect the long-term care system in the future
Challenges Met
Consumer desire for higher quality of life has led to new, innovative forms of care
Integration has improved effectiveness and efficiency of care
Consumers now have much more say in their care
Culture change movement has grown
New Challenges Created by Old Solutions
Desire for cost-effectiveness helped create managed care with improved efficiency, but it created quality and service complaints
Integration improved services and efficiency; some providers haven’t survived
New, consumer-friendly services have created additional demand
Challenges Not Met
System is still reimbursement-driven
Accessibility is not universal
System is highly fragmented and “user-unfriendly”
The number of elderly is growing faster than the system’s ability to meet their needs
Trends to Watch
Changing consumer demographics
The aging of society
Increase in chronic conditions
Greater cultural and ethnic diversity
A consumer-driven system
Focus on quality and outcomes
Quality of care
Patient safety
Quality of life
More Trends to Watch
Changes in the workforce
Growth in demand
Aging of the workforce
Staff shortages
Blending of professional roles
Changes in organization and delivery
Toward a seamless system of care
Consumer-directed care
Technological advances
Even More Trends to Watch
More and better clinical applications
Innovative delivery methods
Special care units
Informal caregivers
New organizational relationships
Among providers
Between providers and payers
Institutional to noninstitutional care
Efficiency
Still More Trends to Watch
Changes in financing and reimbursement
Increase in overall healthcare spending
Decrease in employer-sponsored insurance
Public payers continue to struggle
Providers continue to struggle
Innovative financing
Public/private partnerships
Still More Trends to Watch
Ethical dilemmas
Life-and-death issues
Allocation of resources
Regulation
Health system reform
Summary
The long-term care system is constantly changing, and each change – even if in one small segment – is soon felt throughout the system. These changes will continue and will present both challenges and opportunities for all involved.