Long-Term Care:

Other Countries Tighten Budgets While Seeking Better Access

HEHS-94-154: Published: Aug 30, 1994. Publicly Released: Oct 3, 1994.

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Pursuant to a congressional request, GAO reviewed the provision of long-term care services in Canada, Germany, Sweden, and the United Kingdom, focusing on the: (1) financing and cost-containment measures these countries use to control spending for long-term care; and (2) administrative and delivery approaches the countries use to expand the range of and access to long-term care services.

GAO found that: (1) Germany is using its existing social insurance system to finance long-term care; (2) the United Kingdom currently sets local budgets to control long-term care spending; (3) the Canadian provinces finance long-term care from a variety of sources, mostly supported by general tax revenues; (4) Sweden finances long-term care as a socially insured benefit that is paid for through taxes; (5) Germany will administer long-term care services through sickness funds that will offer a standard package of long-term care benefits; (6) in the United Kingdom, local authorities are responsible for producing a comprehensive plan for meeting the community's long-term care needs; (7) in the United Kingdom, Sweden, and certain Canadian provinces, responsibility for long-term care has been consolidated at the municipal level; and (8) Germany's fragmentation of home and community long-term care among various private organizations has created uneven access to long-term care services.

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