评估需求，提供护理：长期护理需求评估的比较框架

Assessing Needs, Enabling Care:A Comparative Framework for Long- © 2026 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: Hamandi, A., B. Fabiani de Leva, S. Coll-Black, V. Grigoras, andL. Frisina Doetter. 2026. Assessing Needs, Enabling Care: A Comparative Framework for Long- 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 of The World Bank does not guarantee the accuracy, completeness, or currency of the dataincluded in this work and does not assume responsibility for any errors, omissions, ordiscrepancies in the information, or liability with respect to the use of or failure to usetheinformation,methods,processes,or conclusions set forth.The boundaries,colors, 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, for Any queries on rights and licenses, including subsidiary rights, should be addressed to WorldBank Publications, The World Bank, 1818 H Street NW, Washington DC, 20433, USA; fax: 202- Table of Contents 17 25 List of Figures Figure 1:The CARES+ FrameworkFigure 2:Long-Term Care Needs Assessment Process in FinlandFigure 3:Long-Term Care Needs Assessment Process in GermanyFigure 4:Long-Term Care Approval Process in Japan List of Tables Table 1: Overview of Assessment DomainsTable 2: Leading Internationally Recognized Assessment Instruments List of Boxes Box 1: Needs Assessment Instruments for People with Disabilities Acknowledgments This paper is collaboration of the Health, Nutrition, and Population and Social Protectionand Labor Global Practices of the World Bank Group.It was written by Ali Hamandi (SeniorEconomist, World Bank), Beatrice Fabiani de Leva (Research Associate, University of Trieste),Sarah Coll-Black (Senior Social Protection Specialist, World Bank), Vlad Grigoras (Senior Social The paper benefited from peer review by Gisela Mariela Garcia (Health Specialist, WorldBank) and Lucia Solbes Castro (Senior Social Protection Specialist, World Bank). Editing was The team gratefully acknowledges the guidance of Rekha Menon (Practice Manager, World Abbreviations ExecutiveSummary As countries confront the aging of their populations, ensuring that people with long-term care (LTC) needs receive timely and appropriate support has become a centralpolicy priority.Individual needs assessments—structured evaluations of people’s functional, Thispaper fills this gap by introducing the CARES+Framework(which standsforComprehensiveness,Accountability,Regularity,Equity,Standardization,and Personalization) and an accompanying checklist, which provide a structured way todesign, evaluate, and/or compare needs assessment systems across six dimensions:comprehensiveness (the breadth and depth with which multiple domains of need are assessedand the feasibility of doing so in a given system), accountability (the use of qualified andindependent assessors supported by clear grievance mechanisms), regularity (the frequency The comparative analysis reveals substantial diversity in how countries operationalizeneeds assessments, reflecting differences in system maturity, institutional arrangements,and resource environments.Countries with longstanding LTC systems—such as Finland, ExecutiveSummary At the same time, emerging LTC systems demonstrate meaningful progress and anopportunity for systems strengthening.Mauritius’ rollout of a screening approach, SaudiArabia’snational home care standards,and Thailand’s community-based model showgrowing commitment to structured, home-anchored assessments and early identification Across all contexts, the findings underscore that well-designed assessments do morethan determine eligibility: they shape user experience, improve fairness and efficiency, and generate data essential for planning, budgeting, and strengthening service delivery.By using the CARES+ Framework and accompanying checklist, policymakers can diagnosegaps, identify practical reform pathways, and adapt global practices to local realities. Investing Introduction Across the globe, populations are rapidly aging.Declining fertility and rising life expectancyare projected to increase the number of people aged 60 and over from 1.1 billion in 2023 to1.6 billion by 2050, with the population aged 80 and over growing the fastest (WHO 2025; UN While longevity is a sign of social and economic progress, it also brings new challenges. As more people live longer, a growing share will require