Integrated LTC: What can we learn from other countries?

This is a Symposium with 4 papers. The moderator is Gerald M. Eggert, PhD. In the USA LTC is largely an uncoordinated system, with financing/budgeting distinct from service delivery. This fragmentation is presumed to lead to less than optimal patient outcomes and increased cost. The only comprehensive LTC systems in the US are financed by Federal/State Medicaid and the US Veterans Administration. Where are other countries going, and what is the evidence that integrated LTC is better? What are the "take home" lessons for Medicare and Medicaid? Dr. Kodner presents evidence from demonstrations in Canada, Italy, and Australia. Dr. Okamoto presents data about Japan's attempt to convert acute care beds to nursing home use. Dr. Davies present England's trials with improving the efficiency of their LTC system. The last presenter, Ms. Kathy Wilson, describes the Oregon (Medicaid) system, which has had integrated financing and service delivery for the past 25 years. Audience participation will be sought.