评估需求，提供护理：长期护理需求评估的比较框架（英）2026

Assessing Needs, Enabling Care:A Comparative Framework for Long-Term Care Needs AssessmentsPublic Disclosure Authorized © 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-Term Care Needs Assessments. 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. 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,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 WorldBank Publications, The World Bank, 1818 H Street NW, Washington DC, 20433, USA; fax: 202-522-2625; e-mail: pubrights@worldbank.org Table of Contents 7ExecutiveSummary 9Introduction Understanding Individual Needs Assessments:Definition, Components, and Applications 11 17The Multiple Dimensions of a NeedsAssessment: The CARES+ Framework 25Recognizing Opportunities andAcknowledging Constraints 28Global Approaches toNeeds Assessments 46 Conclusion 50References List of Figures Figure 1:The CARES+ Framework18Figure 2:Long-Term Care Needs Assessment Process in Finland29Figure 3:Long-Term Care Needs Assessment Process in Germany32Figure 4:Long-Term Care Approval Process in Japan35Figure 5:Long-Term Care Approval Process in South Korea40Figure 6:Long-Term Care Approval Process in Uruguay44 List of Tables Table 1: Overview of Assessment Domains13Table 2: Leading Internationally Recognized Assessment Instruments16Table 3: The CARES+ Framework Checklist24 List of Boxes Box 1: Needs Assessment Instruments for People with DisabilitiesVersus Long-Term Care Needs 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 SocialProtection Specialist, World Bank), and Lorraine Frisina Doetter (Tenured Senior Lecturer,University of Bremen), with contributions from Cassandra Elizabeth Simmons (Economist,World Bank) and Isabella Castillo (Intern, World Bank). The paper benefited from peer review by Gisela Mariela Garcia (Health Specialist, WorldBank) and Lucia Solbes Castro (Senior Social Protection Specialist, World Bank). Editing wasundertaken by Darcy Gallucio, and design and layout were completed by Razvan Zamfira. The team gratefully acknowledges the guidance of Rekha Menon (Practice Manager, WorldBank) and the financial support provided by the Japan International Cooperation Agency(JICA). 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,cognitive,psychosocial,and/or environmental circumstances—play a critical role indetermining eligibility, tailoring care plans, and guiding system-wide planning. Yet, despitetheirimportance,global guidance on how such assessments can be designed andimplemented remains limited. Thispaper fills this gap by introducing the CARES+Framework(which standsforComprehensiveness,Accountability,Regularity,Equity,Standardization,andPersonalization) 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