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Accessibility to Medical Care - Coggle Diagram
Accessibility to Medical Care
Medical Care
a basic need for the elderly
ageing → may have physical illnesses → need to availability and accessibility to healthcare
Variation
Developed cities → Norway, France and Sweden → less than 5% of elderly skipped health care because of costs
Less developed cities → US → older adults who have trouble paying for healthcare → 11%
Ageing societies → Japan → issues of elderly 60s-70s having to take care of parents 80-90 → increases urgency for provision of physically and financially accessible healthcare
Elderly's response
purchase insurance → TheSilverCare insurance policy by NTUC income in Singapore
death or permanent disability
Outpatient and hospitalisation expenses due to accident
Cost of modifying home to cater for easy mobility
provide training to caregiver
limitations
some may still be unable to afford paying yearly premiums to such insurance policies
Stategies
Making medical care more affordable
Bundled payments
one lump sum payment → insurer helps combine payments into single bundled payment to be divided among all clinicians to → improve transparency and accountability
Accountable Care Organisations
partnership between a group of providers (physicians, hospitals, specialists, rehabilitation centres, long term care facilities) → shared responsibility to deliver quality healthcare → providers agree to accept penalties if they go over budget → more accountable
nationwide insurance or saving programmes
Singapore Medisave
→ individuals put aside income fo future personal or immediate family's hospitalisation
MediShield life
→ basic health insurance plan to pay for large hospital bills and costly outpatient treatment → subsidised treatment in public hospitals
Eldershield
→ long term care insurance scheme for severely disabled, providing monthly payouts of $300-$400
However, affordability still varies for different countries → US costs are much → average hospital costs for a day ~$4000 in US and ~$800 in France
Making homes safer
availability of a caregiver to assist elderly in daily activities
Subsidies in Singapore for seniors to stay in nursing homes / stay at home supported with healthcare services → community / family support → subsidies for adult diapers / nasal tubing / wound dressing
Retrofitting homes
HDB introduced
Enhancement for Active Seniors (EAS) Scheme
in 2012 → subsidies to modify homes to install handrails, lowered switches, non-slip floors etc → however, elderly polled and are only willing to pay <$1000 → can be a financial burden for government
Toyama City in Japan →
Mimamori Link System
→ users can make emergency calls by pressing button → directly contacts emergency centre during crisis
Building New Homes for the Elderly
new project schemes for alternative housing arrangements / public private partnerships → increase the supply of affordable housing for conducive living →
Studio Apartment for elderly in Singapore
→ pre-installed fixtures and fitting (non slip flooring, hand bars etc) + alarm system with neighbourhood link / Senior Activity Centre
Japan driving elderly out of city centre where amenities are easily accessible → cities too expensive for elderly to continue staying → back to city scheme difficult because if space foe elderly tenants is prioritised, there will be an over concentration of old people → lack of systems in place of city run toei apartment complex (2000 housing units) → dozen of people died but was not discovered