Estimating cost of long term care

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    Unit Cost for Long Term Care: Lamsonti District

    Workshop on Long Term Care Policy For Elderly in Thailand The United Nation/ Royal Thai GovernmentJoint team on Social Protection

    26 September 2013

    Thaworn Sakunphanit

    Utoomporn Wongsin

    Santi Labbenchakul

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    Outline

    Background

    Cost of Long term care

    Long term care at Lamsonti

    Objective

    Methodology

    Result

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    Thailand: 91% of LTC are provided by family Source: National Statistic Office

    Source: OECD(2011) Help Wanted? Providing and Paying for LTC

    OECD: size of family care giver is

    at least double that of the formal care workforce

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    Cost of Long Term Care

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    Source: OECD(2007) Conceptual Framework and Methods for Analysis of Data Sources for LTC Expenditure

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    Cost of Long Term Care

    Probability for requirement of the Long term care is very low

    However, the cost of not well managed Long term care is very high

    Study in Bangkok (Worawet,2009) : Average cost in Nursing home was 18,000 Baht

    per month (600 $US)

    Cost for Paid care giver was 8,000 11,000 Baht per month (266-366 $US)

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    Long-term care expenditures

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    Souce: Westerhout & Pellikaan (2005)

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    Modified Barthel Index The Modified Barthel Index, which was developed by Ministry of

    Public Health, consists of 10 items with 20 scores that measure

    a person's daily functioning specifically the activities of daily living

    and mobility.

    Level of dependence Score Level 1 Mild dependent More than 12

    Level 2 Moderate dependent 5-11

    Level 3 Severe dependent 0-4

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    Long Term Care in Lumsonthi District

    Lamsonti

    - A District in Lopburi province

    - Chief district Officer is appointed from Central Gov

    Local Governments - 7 Tambon Administration Organizations Health Care:

    - 1 Community Hospital

    - 7 Health Centres

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    Total Population: 26,284

    Population > 60 years old: 2,169

    Impairment assessment by Modified Bartel ADL index

    - Independent to mild 92%

    - Moderate impairment 7%

    - Severe impairment 1%

    Long term care in Lamsonthi is provided by Formal Care Giver (paid by local gov) and Heath Care Team

    Population in every age groups can enjoy Long term Care

    services include mental disorder

    Long Term Care in Lamsonti

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    References:: Dependency information of Lamsonthi Hospital in fiscal year 2012

    Dependency Information of Lamsonthi District (Fiscal year 2012)

    Elderly (more than 60 years) Non- elderly

    Mild dependent 99 142 241

    Moderate dependent 44 21 65

    Severe dependent 24 13 37

    Total 167 176 343

    The number of members of LTC programmeTotalLevel of dependence

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    Social care by Local

    government

    Health care by health

    facilities

    Empower family care

    HOME BASED Integrated district

    care system

    Long Term Care in Lumsonthi District

    Care givers Environment Health Care

    -Prevention

    -Curative -Rehabilitation

    Oversee by

    Chief District Officer

    Long Term Care in Lamsonti

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    Psychiatrist

    Care giver

    Community nurse

    In-patient Nurse

    Family Donor

    Pharmacist

    Physiotherapist

    Tambon Authority Organisation

    Doctor

    Long Term Care in Lamsonti

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    Specific case

    Long Term Care in Lamsonti

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    Paid Care givers in every sub-district (39)

    Specific case

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    Prepare patient to go back home

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    Modified house

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    From Bed-ridden to mobility

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    How Much did Lumsonthi Spend

    for the Long Term Care? Preliminary result of Cost Accounting Study for

    the Long term care in Lumsonthi Long Term Heath Care Expenditure

    Hospital cost for LTC: 150,000 $us/year in 2012 Average unit cost per case: 32 $US per case

    Health centre cost for LTC

    Long Term Social Care Expenditure Salary Paid care giver: 200 $US per month Other Tambon administration costs

    18

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    Objective

    Estimate cost per day of Community Based (Home care) Long Term Care at Lamsonti

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    Costing method of Ministry of public health Thailand

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    Supporting Cost Centre

    Service Cost centre

    Full cost Full cost

    Full Cost

    Cost Centres Identification T

    raditio

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    eth

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    Accrual basis Accounting

    Allocation factor

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    Methodology

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    -Cost of LTC form hospital: Adjust cost accounting of Lamsothi hospital, which used a traditional costing method of Ministry of

    public health