Healthcare Delivery System: Problems Surrounding Long-Term Care

Long-term care is defined as “the broad array of services and supports people need when they can no longer completely care for themselves” (American Association of Homes and Services for the Aging [AAHSA], 2009).

The supports and services under the long-term care is comprised of nursing home care, adult day care, skilled nursing care, home health care and others. Long term users include the elderly, persons with physical disabilities, persons with chronic diseases like AIDS, diabetes, and emphysema, and persons with developmental disabilities (Agency for Health Research and Quality [AHRQ], 2009). In the United States, supports and services under long-term care is being shouldered by the Medicaid program which is funded by state and federal government.

Today, the health care delivery system is facing many challenges; one of the greatest challenges identified concerns the long-term care. The rapid growth of senior population, widening range of population being catered by long-term care, expensive cost of long-term services, lack of fundings, delay in Medicaid reimbursement and poor quality of services from other long-term care providers are among the most notable factors that contribute to the alarming problem of long-term care (AAHSA, 2009; AHRQ, 2009; Johnson, 2005).

The AHCPR (2009) identified that the rapid increase on the population of elderly alone causes many problems not only to health care providers but also to the government as well.

These include: scarcity on nursing homes and other long-term care facilities, increase in Medicare expenditure; low quality of health services which often results to the patient’s or client’s malnutrition; inappropriate ratio between patients and care attendants due to the decreasing population of nurses and other medical professionals and  lack of budget among care providers because of the increasing cost of long-term care and decreasing allocation of health budget and health sponsorship.

The widening scope of long-term care which now include other people who are suffering from physical, mental and developmental disability and chronic diseases also contribute to the problematic condition of long-term care.

This phenomena requires that the  reform in healthcare and medical insurance be done in order to adapt with these rapid changes. Moreover, since medical technology is becoming more advanced, expenses on availing highly advanced medical services is noted to be dramatically increasing.

The cost of availing Medicaid insurance is also becoming more and more expensive; thus, those who could not afford this insurance and other private long-term care insurance are contributing to the growing numbers of uncured and unattended patients which then affects the quality of healthcare. Medical practitioners as well as insurance holders are now affected by delays in reimbursement of Medicaid, thus the increase in Medicaid cost would add more to their present burden.

In order to solve this problematic condition of long-term care, the government, together with medical professionals, must devise a more comprehensive program that would address each component of the prevailing problem concerning long-term care. As the quote “prevention is better than cure” applies, both the government and healthcare institutions should find ways to prevent the growing problems associated with long-term care.


Agency for Healthcare Research and Quality. (2009). AHCPR Research on long-term care. U.S. Department of health and Human Services. Retrieved July 29, 2009, from

American Association of Homes & Services for the Aging. (2009). The Problem. AAHSA. Retrieved July 29, 2009, from

Johnson, K.A. (2005). The Looming Problem of Long-Term Care and Medicaid Spending. The Heritage Foundation. Retrieved July 29, 2009, from