Long-term care financing: lessons for low- and middle-income settings: brief 8: ensuring financial sustainability in long-term care
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Date
Journal Title
Journal ISSN
Volume Title
Publisher
World Health Organization
Abstract
Description
10 p.
The Portuguese version is published by PAHO: https://iris.paho.org/handle/10665.2/63358
The Spanish version is published by PAHO: https://iris.paho.org/handle/10665.2/64460
This policy brief examines strategies to ensure the financial sustainability of long-term care (LTC) systems, with particular relevance for low- and middle-income countries. It discusses how countries can balance revenues and expenditures while maintaining equitable access to needed services as population ageing increases demand for care. Drawing on international experiences, the brief reviews approaches used in mature LTC systems, including revenue targeting, global budgeting, intergenerational financing, diversification of funding sources, and mechanisms to address local funding gaps. It also explores the role of taxation, labour market policies and public investment in strengthening the foundations of sustainable LTC systems. The document analyses cost-containment measures, including changes in service delivery models, supply-side constraints and demand-management policies, highlighting the importance of monitoring their effects on unmet needs and financial protection. It further considers the contribution of assistive technologies, housing adaptations and health promotion throughout the life course in delaying the need for intensive care. The brief emphasizes that investments in prevention, management of chronic conditions, and the development of LTC institutions, workforce and financing mechanisms can support long-term sustainability while protecting access to care and promoting broader social and economic benefits.
The Portuguese version is published by PAHO: https://iris.paho.org/handle/10665.2/63358
The Spanish version is published by PAHO: https://iris.paho.org/handle/10665.2/64460
This policy brief examines strategies to ensure the financial sustainability of long-term care (LTC) systems, with particular relevance for low- and middle-income countries. It discusses how countries can balance revenues and expenditures while maintaining equitable access to needed services as population ageing increases demand for care. Drawing on international experiences, the brief reviews approaches used in mature LTC systems, including revenue targeting, global budgeting, intergenerational financing, diversification of funding sources, and mechanisms to address local funding gaps. It also explores the role of taxation, labour market policies and public investment in strengthening the foundations of sustainable LTC systems. The document analyses cost-containment measures, including changes in service delivery models, supply-side constraints and demand-management policies, highlighting the importance of monitoring their effects on unmet needs and financial protection. It further considers the contribution of assistive technologies, housing adaptations and health promotion throughout the life course in delaying the need for intensive care. The brief emphasizes that investments in prevention, management of chronic conditions, and the development of LTC institutions, workforce and financing mechanisms can support long-term sustainability while protecting access to care and promoting broader social and economic benefits.
Keywords
Aged, Long-Term Care, Developing Countries, Delivery of Health Care, Insurance, Long-Term Care, Workforce, Social Work, Investments, Healthcare Financing, Health Services Needs and Demand, Health Expenditures, Cost-Benefit Analysis, Housing, Taxes, Dementia, Stroke, Health Services for the Aged, economics