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System-Level Factors Affecting Long-Term Care Wait Times: A Scoping Review.

Erin L Scott1, David Rudoler2,3, Jana Ferma3

  • 1Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

Canadian Journal on Aging = La Revue Canadienne Du Vieillissement
|February 21, 2024
PubMed
Summary

Long-term care (LTC) waitlists are growing due to system-level issues, not just individual factors. Addressing waitlist management and community care capacity is crucial for improving access.

Keywords:
aginglistes d’attentelong-term careobstacles systémiquesscoping reviewsoins de longue duréesystemic barriers to carevieillissementwait listsétude de portée

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Area of Science:

  • Healthcare Management
  • Public Health Policy
  • Gerontology

Background:

  • Growing demand for long-term care (LTC) services, driven by aging populations.
  • Existing literature primarily addresses individual-level factors influencing LTC access.
  • Limited understanding of system-level determinants contributing to extended LTC waitlists.

Purpose of the Study:

  • To conduct a scoping review identifying system-level factors contributing to long-term care waitlists.
  • To synthesize current knowledge on barriers to timely access to long-term care services.

Main Methods:

  • Scoping review of literature published between 2000 and 2022.
  • Inclusion/exclusion criteria based on publication year, language, focus, and document type.
  • Qualitative content analysis of 17 selected studies from an initial 815 abstracts.

Main Results:

  • Ten key system-level factors were identified: waitlist management styles, inconsistent admission standards, personnel shortages, insufficient community-based care, inequitable service distribution, lack of system integration, insurance plan consequences, ranking preferences, supply/demand imbalances, and financial incentives.
  • Waitlist management, community care capacity, and demographic trends emerged as key areas for intervention.
  • Significant system-level barriers impede timely access to long-term care.

Conclusions:

  • Interventions targeting waitlist management, community-based care capacity, and demographic trends are recommended to improve LTC access.
  • Further research is essential to address systemic barriers hindering timely access to long-term care.
  • System-level factors significantly impact long-term care accessibility and require targeted policy and operational improvements.