ArticleBMC health services research2024
Needs assessment in long-term care: expression of national principles for priority setting in service allocation.
Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Municipal intermediate care services in Denmark and Norway: a cross-country comparative analysis.Scandinavian journal of primary health care · 2026Article
- Unseen and unread decision letters in everyday care: a case study of medication management assistance in Norwegian municipal home healthcare.Scandinavian journal of primary health care · 2026Article
- What is required for digital care and support technologies to be experienced as good care by community-dwelling older adults? A qualitative study.BMC health services research · 2026Article
- A Comparison of the Long-Term Care Systems in Norway and England.Health services insights · 2026Review
- Prioritizing Long-Term Care Services for Disabled Older Adults: A Cross-Sectional Study Using the Kano Model and Entropy-Weighted TOPSIS.Journal of nursing management · 2026Article
- Enhancing home care nursing in the Netherlands: how can organisations facilitate the improvement of needs assessments in home care nursing? A focus group study.BMC health services research · 2025Article
- Aging in place or aging out of place? Family caregivers' perspectives on care for older Pakistani migrants in Norway.European journal of ageing · 2024Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundLong-term care services for older adults are characterised by increasing needs and scarce resources. Political strategies have led to the reorganisation of long-term care services, with an increased focus on "ageing in place" and efficient use of resources. There is currently limited research on the processes by which resource allocation decisions are made by service allocators of long-term care services for older adults. The aim of this study is to explore how three political principles for priority setting in long-term care, resource, severity and benefit, are expressed in service allocation to older adults.
methodsThis qualitative study uses data from semi-structured individual interviews, focus groups and observations of service allocators who assess needs and assign long-term care services to older adults in Norway. The data were supplemented with individual decision letters from the allocation office, granting or denying long-term care services. The data were analysed using reflexive thematic analysis.
resultsThe allocators drew on all three principles for priority setting when assessing older adults' long-term care needs and allocating services. We found that the three principles pushed in different directions in the allocation process. We identified six themes related to service allocators' expression of the principles: (1) lowest effective level of care as a criterion for service allocation (resource), (2) blanket allocation of low-cost care services (resource), (3) severity of medical and rehabilitation needs (severity), (4) severity of care needs (severity), (5) benefit of generous service allocation (benefit) and (6) benefit of avoiding services (benefit).
conclusionsThe expressions of the three political principles for priority setting in long-term care allocation are in accordance with broader political trends and discourses regarding "ageing in place", active ageing, an investment ideology, and prioritising those who are "worse off". Increasing attention to the rehabilitation potential of older adults and expectations that they will take care of themselves increase the risk of not meeting frail older adults' care needs. Additionally, difficulties in defining the severity of older adults' complex needs lead to debates regarding "worse off" versus potentiality in future long-term care services allocation.
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