Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Zecevic Aleksandra

Abstract

Failures of long-term care (LTC) policies caused undesirable negative outcomes for Canadian long term care residents during the COVID-19 pandemic. The purpose of this study was to explore similarities and differences in LTC policies between Ontario (Canada, Ontario), China, and Japan and identify potentially beneficial ideas for policy improvement in all countries. An adapted framework for comparing health care systems guided data collection. Information about four major policy areas: regulation, service provision, PSW workforce, and financial policies was extracted from LTC policy documents, government reports, and research articles. Data was described and compared for similarities and differences. Findings show that LTC policies reflect distinct cultural contexts and core principles of policymaking. Ontario focuses on patient-centered care, China aims to ensure the basic LTC services, and Japan aspires to keep older adults living independently. Knowledge gained from this comparative analysis may contribute to the improvement of LTC home systems everywhere.

Summary for Lay Audience

Weaknesses in long-term care policies and poor response to unexpected events may cause serious negative consequences for older people living in long-term care homes. Problems COVID-19 caused in Canadian long-term care homes provide a good example. However, other countries, such as China and Japan had different, more positive, experiences during the pandemic. The purpose of this study was to describe long-term care policies in Ontario (Canada), China, and Japan, compare the similarities and differences in regulations, how service is provided, rules that govern personal support workers, and financial policies. The goal was to identify ideas and lessons worth learning from each other to improve the quality of long-term care provision. To guide data collection, the author used an adapted version of a framework for comparing health care systems. Data from LTC policy documents, government reports and research articles were extracted in a table and compared for similarities and differences. Results show that all three countries have numerous policies that govern the provision of services, have similar challenges with regulating and educating personal supported workers, and provide subsidies to both residents and long-term care homes. The study also revealed differences in details of the long-term care policies related to cultural contexts and core principles guiding each country’s philosophy of care. The Ontario (Canada) policies aim to provide patient-centered care, the Chinese policies are guided by the need to develop as many long-term care homes as possible for the rapidly growing population of older adults, and the Japanese policies are trying to keep older adults living independently for as long as possible. The study revealed valuable lessons worth learning from each country.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Available for download on Thursday, June 30, 2022

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