OECD working paper. The economics of patient safety Part III: Long-term care (17 September 2020)

Summary

A fundamental shift is underway in care provision for older populations, with long-term care (LTC) increasingly taking on care provision that was traditionally delivered in hospitals. As OECD populations are rapidly aging, there has been increasing demand on the LTC sector to provide care for more, and older people, with complex conditions and heightened needs for expert care.

Currently, 58% of adults aged 65 or over report living with two or more chronic diseases, with this figure rising over 70% in many OECD countries. Simultaneously, trends in LTC focus on substitution of care settings from nursing homes and residential care towards home care and supporting older persons to live on their own or with family as long as possible.

The total cost of avoidable admissions to hospitals from LTC facilities in 2016 was almost USD 18 Billion, equivalent to 2.5% of all spending on hospital inpatient care or 4.4% of all spending on LTC. Research shows that over half of the harm that occurs in LTC is preventable, and over 40% of admissions to hospitals from LTC are avoidable. The root causes of these events can be addressed through improved prevention and safety practices and workforce development—including skill-mix and education. Targeted investments in a number of key areas can have a significant impact by mitigating the main cost drivers of adverse events in LTC.