Cost analysis of day care centres in Norway.

BACKGROUND: Day care services aim to offer meaningful activities and a safe environment for the attendees and a respite for family caregivers while being cost effective. This study compares the use of formal and informal care in users and non-users of day care centres designed for persons with dementia. METHOD: Users of day care designed for dementia (DC group) and non-users (NDC group) were followed over a period of 24 months or until nursing home admission (NHA) respectively death. Demographic and clinical characteristics were collected at baseline and after 12 and 24 months. The use of care was recorded by Resource Utilization in Dementia (RUD). RESULTS: A total of 257 persons with dementia participated in the study, 181 in the DC group and 76 in the NDC group. Users of day care centres cause higher costs due to the expenses for day care, while neither the use of home nursing, secondary care, informal care nor the time until NHA did show any differences between users and non-users. The overall costs were higher in the DC group at baseline and after 12 months, but this difference was no longer present at the end of the two-year study period. CONCLUSION: Our results indicate no potential cost-saving effect of day care designed for people with dementia, as the use of day care did neither result in a reduced use of care nor in a delay of NHA. Future research should balance the non-monetary benefits of day care against its costs for a full cost-effectiveness analysis, most favourable in a RCT-design.

Per Diem Paid to States for Care of Eligible Veterans in State Homes. Final rule.

This rulemaking adopts as final, with changes, proposed amendments to VA's regulations governing payment of per diem to States for nursing home care, domiciliary care, and adult day health care for eligible veterans in State homes. This rulemaking reorganizes, updates, and clarifies State home regulations, authorizes greater flexibility in adult day health care programs, and establishes regulations regarding domiciliary care, with clarifications regarding the care that State homes must provide to veterans in domiciliaries.

Building Long-Term Care Policies in Latin America: New Programs in Chile.

BACKGROUND: Little is known about long-term care policies in developing regions. Latin America is one of those regions. In less than 20 years, it will surpass Europe's elderly population. At that point, Chile will be the country with the largest share of elderly population in the region. For that reason, long-term care pilot programs have been implemented in recent years. OBJECTIVE: This article describes the long-term care policy in Chile, analyzed according to the international experience. METHOD: National directors of these programs were asked to complete questionnaires with a description of each, and the results of the past year. This information was compared with interviews to experts and official information available online. RESULTS: Programs follow the international trends, although they are underfinanced and lack the necessary mechanisms to control service quality. CONCLUSION: It is suggested that budgets should be increased, and there should be higher requirements for caregiver training. Also, mechanisms for quality control should be established, and policies should be evaluated for formal direct hiring through a cash-for-care system.