Birgit Trukeschitz

Dutch translation and cross-cultural validation of the Adult Social Care Outcomes Toolkit (ASCOT)

BackgroundThe Adult Social Care Outcomes Toolkit was developed to measure outcomes of social care in England. In this study, we translated the four level self-completion version (SCT-4) of the ASCOT for use in the Netherlands and performed a cross-cultural validation.MethodsThe ASCOT SCT-4 was translated into Dutch following international guidelines, including two forward and back translations. The resulting version was pilot tested among frail older adults using think-aloud interviews. Furthermore, using a subsample of the Dutch ACT-study, we investigated test-retest reliability and construct validity and compared response distributions with data from a comparable English study.ResultsThe pilot tests showed that translated items were in general understood as intended, that most items were reliable, and that the response distributions of the Dutch translation and associations with other measures were comparable to the original English version. Based on the results of the pilot tests, some small modifications and a revision of the Dignity items were proposed for the final translation, which were approved by the ASCOT development team. The complete original English version and the final Dutch translation can be obtained after registration on the ASCOT website (http://www.pssru.ac.uk/ascot).ConclusionsThis study provides preliminary evidence that the Dutch translation of the ASCOT is valid, reliable and comparable to the original English version. We recommend further research to confirm the validity of the modified Dutch ASCOT translation.

Long-Term Care Financing in Austria

With a universal long-term care (LTC) allowance programme, subsidized LTC services for dependent persons and a new programme coping with migrant care work in private households, Austria today is one of the European Union (EU) countries addressing the issue of LTC in a substantial manner. In 2006, Austria spent slightly less than 1 per cent of its GDP on care for elderly people alone, ranking the country fourth in the EU-25, behind Sweden (2.4 per cent), Denmark (1.7 per cent) and Norway (1.6 per cent) (Eurostat, 2010).

Der Einfluss öffentlicher Beschaffungspolitik auf Sozialmärkte: Ein Konzept zur Analyse beschaffungspolitischer Effekte auf das Dienstleistungsangebot sozialer Nonprofit-Organisationen

Eine wesentliche Leistung moderner Wohlfahrtsstaaten besteht darin, die Lebensbedingungen benachteiligter Personen oder Personengruppen durch vielfaltige Angebote der Beratung, Betreuung, Behandlung oder Pflege zu verbessern. Solche sozialen Dienstleistungen werden zunehmend auf Sozialmarkten angeboten und nachgefragt. Sozialmarkte werden wegen der spezifischen Eigenschaften des Gutes, der Angebots- und der Nachfrageseite in vielen Landern staatlich reguliert. Sie lassen sich zudem als gemischte Markte (“mixed markets”) klassifizieren, da auf ihnen offentliche und private Anbieterlnnen prasent sind. Vor diesem Hintergrund werden Sozialmarkte auch als „Quasi-Markte“1 bezeichnet.

Sarkopenie vorbeugen durch Bewegung im betreuten Wohnen

Sarkopenie, ubersetzt die Fleischarmut (griech. sarka = Fleisch, penia = Mangel, Armut), meint den altersbedingten und normalen Verlust an Skelettmuskelmasse, sofern keine Erkrankung oder eine strenge Diat als Ursachen vorliegen. Bei einem uber der Alters- und Geschlechtsnorm liegenden Verlust der Muskelmasse kommt es jedoch zu einem deutlichen Verlust der Funktionskapazitat des Herzkreislauf- und Stoffwechselsystems, was sich im Alltag in einer Abnahme der Kraftfahigkeit und Reduzierung der Gehgeschwindigkeit ausern kann.

Understanding Long-Term Care Outcomes: The Contribution of Conventional and Behavioral Economics

Aging societies are confronted by a growing need for adequate and reliable long-term care (LTC). Against the background of limited financial resources, measurement of LTC outcomes has attracted increasing interest. This chapter discusses how conventional and behavioral economic approaches contribute to our understanding of LTC outcomes and how LTC outcomes can be measured. A production-centered approach is used to identify final LTC outcomes that indicate the impact of LTC on care recipients’ and carers’ quality of life (QoL). Conventional economic approaches assume rational, utility-maximizing individuals as well as perfect markets and suggest that it is possible to measure LTC outcomes indirectly, using revealed-preference approaches, with preferences inferred from care recipients’ choices. However, behavioral economics holds that revealed preferences are not a reliable starting point for measuring QoL gains from LTC services. At the same time, behavioral economists also caution against taking self-assessments of QoL outcomes and stated-preference approaches in economic evaluation at face value. Whichever approach is being followed to measure LTC outcomes, at least three issues need to be addressed: specifying LTC outcome domains, eliciting preferences for these domains, and measuring the impact of LTC on QoL.

Federalism in Health and Social Care in Austria

In Austria, health and social care are organized in separate systems, which themselves are fragmented and display substantial degrees of fiscal as well as parafiscal federalism. While a major part of healthcare funding is based on contributions to mandatory social health insurance, social care is not part of the country’s Bismarckian tradition and remains essentially tax-funded. As a consequence, health care, on the one hand, and social care, on the other hand, are characterized by different degrees and flavors of federalism. The federal government as well as the country’s provinces take responsibilities in health and social care. Self-governed social health insurance is a more visible player in health care, where its regional bodies determine financing and delivery in outpatient and rehabilitative care.