长期护理ABC：系统能力建设的功能框架（英）2025

The ABCs of Long-Term Care:A Functional Framework forBuilding System CapacityPublic Disclosure Authorized © 2025 International Bank for Reconstruction and Development / The World Bank1818 H Street NW, Washington DC 20433 Telephone: 202-473-1000Internet:www.worldbank.org Attribution Please cite the work as follows: Frisina Doetter, L., A. Hamandi, S. Coll-Black, and V. Grigoras.2025. The ABCs of Long-Term Care: A Functional Framework for Building System Capacity.Washington DC: World Bank. This work is a product of the staff of The World Bank with external contributions. The findings,interpretations, and conclusions expressed in this work do not necessarily reflect the views ofThe World Bank, its Board of Executive Directors, or the governments they represent. TheWorld Bank does not guarantee the accuracy,completeness,or currency of thedata included in this work and does not assume responsibility for any errors, omissions,or discrepancies in the information, or liability with respect to the use of or failure to usethe information, methods, processes, or conclusions set forth. The boundaries, colors,denominations, and other information shown on any map in this work do not imply anyjudgment on the part of The World Bank concerning the legal status of any territory or theendorsement or acceptance of such boundaries. Nothing herein shall constitute or be construed or considered to be a limitation upon or waiverof the privileges and immunities of The World Bank, all of which are specifically reserved. Rights and Permissions The material in this work is subject to copyright. Because The World Bank encouragesdissemination of its knowledge, this work may be reproduced, in whole or in part, fornoncommercial purposes as long as full attribution to this work is given. Any queries on rights and licenses, including subsidiary rights, should be addressed to World BankPublications, The World Bank, 1818 H Street NW, Washington DC, 20433, USA; fax: 202-522-2625;e-mail:pubrights@worldbank.org Photo Credits Page 13: © Mohamad Al-Arief / World Bank Group. Further permission required for reuse.Page 18: © Dominic Chavez / World Bank Group. Further permission required for reuse.Page 21: © Jutta Benzenberg / World Bank Group. Further permission required for reuse.Page 30: © Shutterstock / Guillermo Spelucin RPage 74: © Shutterstock / Guillermo Spelucin RPage 81: © Arne Hoel / World Bank Group. Further permission required for reuse.Page 83: © www.freepik.com / pvproductionsCover design: Razvan Zamfira / Studio Interrobang Table of Contents 8ExecutiveSummary 12Introduction 13Making the Case forLong-Term Care 18Translating the Case for LTCinto System Strengthening 21Laying the ConceptualFoundation for LTC Systems 30 A Functional Framework for Building SystemCapacity in LTC Systems 74 Putting the Pieces Together toBuild Stronger LTC Systems 81PolicyNext Steps List of Figures Figure 1:Effective Policies Can Shorten Hospital17Figure 2:National Definitions Have Practical Implications24Figure 3:LTC Systems Often Span Two Sectors34Figure 4:Financing Determines How Resources Are Generated, Pooled, and Allocated,Based on Governance Rules41Figure 5:Public Mobilization of Resources Varies Across Countries48Figure 6:Classification of Caregivers53Figure 7:Services and Support Delivery: Domains and Cross-Cutting Enablers59Figure 8:Technology & Innovation: An Enabler, Not Just a Tool68Figure 9:A Functional Framework for Building System Capacity in LTC79 List of Tables Table 1: The Case for Strong Government Stewardship and Public Investment in LTC16 Table 2: Comparing Definitions of LTC23Table 3: Comparing Definitions and Their Implications in Germany, Japan,and United States25Table 4: Who Should Lead LTC Policy and Coordination?35Table 5: Population Needs Assessments to Inform Policy36Table 6: Key Policy Activities and Actions Under LTC Governance37Table 7: Putting Mobilization into Practice: Governance vs. Financing Function43Table 8: Putting Direction into Practice: Governance vs. Financing Function in Japan44Table 9: Key Policy Activities and Actions Under LTC Financing46Table 10: Key Policy Activities and Actions Under LTC Human Resources57Table 11: Putting Planning into Practice: Governance vs. Delivery of Services and Support62Table 12: Putting Delivery into Practice: Governance vs. Delivery of Services and Support64Table 13: Key Policy Activities and Actions Under LTC Services and Support67 List of Boxes Box 1: LTC Is Largely Provided by Women15Box 2: The Core Functions of the LTC System20Box 3: Key Institutional Definitions of LTC23Box 4: Benefits of Early Access to LTC Services for Healthy Aging for Maria - A Vignette27Box 5: What Is Person-Centered Care?28Box 6: Despite Definitional Variation, Core Aspects Converge29Box 7: Defining Integration and Continuity of Care31Box 8: Models of Governance in LTC: Country Examples40Box 9: Main Financing Models Used for LTC Systems51Box 10: Key Types of Services and Suppo