当政策与现实相结合时:在LTC支出上升的背景下,市政领导人的看法
Trond Tjerbo1, Terje P Hagen1, Jon Helgheim Holte1
1Department of Health Management and Health Economics, University of Oslo, Norway.
Health services insights
|January 19, 2026
概括
由于具有复杂需求的年轻用户和劳动力短缺,长期护理成本正在上升. 由于国家政策和地方预算之间的财政不对称性,市政领导人面临管理这些成本的挑战.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 医疗保健管理的管理
背景情况:
- 挪威的长期护理 (LTC) 支出明显超过了国内生产总值的增长.
- 虽然老龄化是一个已知的因素,但年轻的用户 (<60岁) 占高成本LTC用户的比例不成比例.
- 2019年,前5%的高成本用户占LTC总支出的39%.
研究的目的:
- 调查市政领导人对LTC支出增长背后的关键驱动因素的看法.
- 确定市政当局在管理LTC成本方面面临的最紧迫挑战.
主要方法:
- 从2023年11月到2024年2月,与13名市政领导人进行了半结构面试.
- 通过专题分析,探索领导者对支出增长,其原因和相关挑战的看法.
- 在KOSTRA集团中,城市被战略性地选择,以确保人口和财务多样性.
主要成果:
- 市政领导人强调,具有复杂心理健康需求的年轻用户是重要的成本驱动因素.
- 劳动力短缺被认为是迫使人们依赖昂贵的外部服务.
- 扩大权利和任务,加上财政不对称性,在服务期望和市政能力之间造成了差距.
结论:
- LTC支出增长受到人口趋势和治理问题的影响.
- 年轻用户和劳动力挑战直接增加了成本.
- 财政不对称性阻碍了市政当局将服务调整到可用资源的能力,加剧了成本压力.
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