Cost-benefit analysis in social care for elderly people

Social care at home for elderly people is now growing rapidly in France. A new question is, What are better forms of care for the different partners concerned? The research presented here, and made for the Comity of Lille Employment Area with cooperation of the Caisse Primaire d'Assurance Maladiede Lille (the local board of the national social security system), offers some answers to that question. Ceteris paribus, cultural activities-in a group or at home-versus others appear to produce more interest for elderly, professional caregivers, and the rest of society.     

Japan's financing system for health care of the elderly

The multiplicity of Japan's health insurance system fails to achieve equality among the different insurance groups of the sharing of the financial burden. This "horizontal" inequality is effectively offset by a unique redistribution mechanism established in 1982. However, there is no reserve fund so that savings can be accumulated for the greater financial need in the future. This will inevitably lead to a heavier financial burden for the future working generation or more utilization of the personal assets of the elderly. How to achieve "vertical" or intergenerational equality in financing the cost of health care for the elderly is the biggest social policy challenge for Japan.     

Purpose and method for the evaluation of interpersonal process in health and social care

This article is concerned with the evaluation of the process of interaction between professionals and clients in health and social care. The literature is reviewed to identify examples of this kind of process evaluation and the reported studies are analysed with regard to the purposes of the evaluations and the methods employed. A novel categorisation of purpose is proposed which identifies five main purposes: confirmatory when the process is being checked to assess compliance with stated plans and intentions; causal when the intention is to link aspects of the process with outcomes; experimental when the process is being manipulated to compare outcomes for experimental and control groups; stakeholder perspectives when the process is being evaluated from the standpoint of stakeholders; formative/summative feedback when the process is being described to provide feedback to providers; and finally, exploratory when an under-researched or poorly understood process is being investigated to identify its main features. Methods for evaluating interpersonal process are described and the implications of this kind of evaluation are discussed.     

Religion, social support, and health among the Japanese elderly

We address three issues in this paper: (1) Is religion related to self-rated health, (2) do these salubrious effects arise because religion encourages people to provide help to significant others, and (3) is the relationship between religion and helping others more evident among older men than elderly women? We analyze the relationships among religion, support giving, and health with data provided by a national probability sample of 2,153 older people in Japan who were interviewed face-to-face in 1996. Greater involvement in religion is associated with providing help to others more often, but these effects emerge for older men only. Regardless of gender, elders who provide assistance to others more often rate their health more favorably than older adults who are less involved in helping others. These results confirm that religion is related to health, and that helping others may explain at least part of the reason for this relationship.     

Introspection as intra-professionalism in social and health care

This article analyses two cases from health and social care, adopting a psycho-societal approach. The analysis highlights how professionalism evolves and develops through an introspection of the relational and scenic processes between professionals, as well as between the professional and the client or patient. As a phenomenon at the core of professional practice, it will be argued that introspection needs to recognize and encompass the intra- and inter-psychic responses and understandings of professionals and their clients and patients. The first case places supervision as a learning space, where framing and complex exchanges of loss and confirmation, and of denial and displacement take place between a group of social workers and their supervisor. In the second case, it becomes apparent how the research interview opens up an opportunity for processing the emotions and socially critical experiences involved in hospital work.     

Payment mechanisms for social work in health care: Today and tomorrow

Accepting the establishment of a national health policy as iminent, this paper surveys the way social work services are organized and financed within the health care system. It also outlines what measures can be taken to ensure the inclusion and importance of the profession within this system, and what developments can be expected in the next ten years.     

Interprofessional collaboration in Swedish health and social care from a care manager's perspective

The aim of this study was to study interprofessional collaboration in health and social care for older people and persons with disabilities from a care manager's perspective. The empirical data was collected at a workshop held during a national conference for care managers and through focus group interviews in two Swedish municipalities. The results showed that the care managers collaborated in different ways with many different professionals from different organisations. The care and discharge planning meetings emerged as the most typical situation where care managers collaborated with different health care professionals. Interprofessional collaboration was seen as a means for care managers to fulfil their assignment and carry out their work. The care manager role encompassed role strain, a relatively weak professional identity, and differences in professional status among those involved in interprofessional collaboration.     

Uniform assessments and standards of social and health care services.

This paper describes the procedures and methodology used in the development of a model In-Home Care services program for aged and disabled adults in Washington State. This program was designed to replace the existing Title XX chore services program in two geographic regions in which dissimilar chore service usage patterns have been exhibited by similar types of recipients. An analysis of the resultant cost, service utilization, and recipient health status data suggests that in the model program home-based services for the aged and disabled were provided in a more equitable and cost-effective manner than is the case with the existing chore service program in this state.     

A model of social work classification in health care

Abstract

The introduction of casemix funding for Australian acute health care services has challenged Social Work to demonstrate clear reporting mechanisms, demonstrate effective practice and to justify interventions provided. The term ‘casemix’ is used to describe the mix and type of patients treated by a hospital or other health care services. There is wide acknowledgement that the procedure-based system of Diagnosis Related Groupings (DRGs) is grounded in a medical/illness perspective and is unsatisfactory in describing and predicting the activity of Social Work and other allied health professions in health care service delivery. The National Allied Health Casemix Committee was established in 1991 as the peak body to represent allied health professions in matters related to casemix classification. This Committee has pioneered a nationally consistent, patient-centred information system for allied health. This paper describes the classification systems and codes developed for Social Work, which includes a minimum data set, a classification hierarchy, the set of activity (input) codes and ‘indicator for intervention’ codes. The advantages and limitations of the system are also discussed.     

National policy approaches to social care for elderly people in the United Kingdom and Singapore 1945-2002

The authors compare policy approaches in the United Kingdom and Singapore on social care for older persons. The context of these approaches is discussed showing the development of policies, in each country from the aftermath of the Second World War to the present. Given that Singapore is a former British colony, it is of interest to scholars of social policy to examine its welfare approach as compared to the welfare state approach espoused by the United Kingdom. Both nations are faced with the challenges of an aging population, which necessitates handling similar problems with strategies that are in harmony with their respective economic, social, and cultural contexts. This paper considers their divergence of philosophies and policies, concluding with the recognition that the major difference lies in national and governmental expectations regarding the extent of the financial and regulatory responsibility for care for older people carried by the individual, the family, and the state.     

National registry of health care providers in clinical social work

News of the societies

National registry of health care providers in clinical social work     

The barriers to the effectiveness of culturally sensitive practices in health and social care services for Chinese people in Britain

This paper studies the problem that health and social care practitioners, intending to satisfy their ethnic minority users’ cultural preferences, end up providing services against their wishes. In particular it points out that this problem is caused by over-emphasising two key assumptions of ethnic minority groups. The first assumption is that all members of the same ethnic minority group organise their health and social care according to their cultural principles. The second assumption is that their cultural principles are monolithic. Demonstrating that these two assumptions may not necessarily be applicable to all ethnic minority groups, this paper discusses the diverse strategies used by Chinese people in Britain to organise their health and social care, and the differences between their two important cultural principles, Taoism and Confucianism. In order to demonstrate to professionals and the Government that they should not over-emphasise these two assumptions and that they need to pay attention to ethnic minority groups’ diverse needs, the paper suggests that different ethnic minority groups may need to unite to increase their influence in the service provision process. However it also warns that this tactic may lead to the subordination of minority group interests in the articulation of those large groups.