Introduction and Summary

  • Joshua M. Wiener
Conference paper
Part of the Keio University Symposia for Life Science and Medicine book series (KEIO, volume 4)


While the previous section addressed the macro issues in constructing long-term care programs (such as whether the program is means-tested or provides universal coverage), this segment discusses the “nuts-and-bolts” program design decisions that must be made. In general, program managers must operate under the dual constraint of meeting the needs of the disabled elderly while at the same time keeping expenditures within politically acceptable levels (remembering that the politically acceptable level varies greatly around the world). Although there are an endless number of program design issues, there are five issues that stand out in importance: eligibility determination, the role of care planning and case management, what services are to be provided, how services are to be reimbursed, and quality assurance.


Case Management Home Care Dual Constraint Home Care Worker Eligibility Determination 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Tokyo 1999

Authors and Affiliations

  • Joshua M. Wiener

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