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

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.