Analysis of Cost Control and Quality Improvement Paths for Geriatric Elderly Care Services under Long-term Care Insurance
Main Article Content
Abstract
Efficient management of large-scale service systems requires robust information integration, intelligent resource allocation, and data-driven decision support. This study proposes a cost-control and quality-optimization framework based on multimodal data fusion, efficiency evaluation, and simulation-driven decision analysis. Heterogeneous information from administrative records, clinical indicators, caregiver surveys, and policy datasets is integrated through a unified data-processing architecture to support comprehensive system assessment. Principal component analysis, regression modeling, and Super-SBM efficiency evaluation are employed to identify key determinants affecting service utilization, resource allocation, and outcome performance. To further enhance system adaptability, Monte Carlo simulation and agent-based modeling are incorporated to characterize uncertainty propagation, dynamic interactions, and long-term optimization effects. Experimental results demonstrate that the proposed framework improves service efficiency by up to 18%, reduces out-of-pocket expenditure by 15%, decreases caregiving burden by 20%, and enhances overall quality-of-life indicators by 14% under simulated conditions. The proposed framework provides an effective methodology for heterogeneous information fusion, intelligent decision support, system-level optimization, and dynamic resource management, offering potential applications in distributed monitoring, data-driven service systems, and complex networked environments.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
References
A. Honda, T. Nishida, M. Ono, T. Tsukigi, and S. Honda, “Impact of financial burden on family caregivers of older adults using long-term care insurance services,” SAGE Open Nursing, vol. 11, Art. no. 23779608251383386, 2025, doi: 10.1177/23779608251383386.
T. Zhang, Z. Hu, K. Zhang, and X. Li, “The impact of long-term care insurance on household expenditures of the elderly: evidence from China,” Plos one, vol. 20, no. 4, Art. no. e0316758, 2025, doi: 10.1371/journal.pone.0316758.
R. Watanabe, M. Saito, K. Ide, and K. Kondo, “Difference in long‐term care cost obtained with the short‐term intensive prevention service (day service type C ): A 3‐year follow‐up study of Japanese older adults,” Geriatrics & Gerontology International, vol. 25, no. 8, pp. 1058-1064, 2025, doi: 10.1111/ggi.70102.
C. Shao, Y. Shangguan, and W. Li, “Can long-term care insurance change eldercare patterns? Evidence from China,” Journal of Aging & Social Policy, vol. 37, no. 3, pp. 375-394, 2025, doi: 10.1080/08959420.2024.2384183.
R. M. Drost, G. A. van Mastrigt, S. Vluggen, S. F. Metzelthin, M. H. Bleijlevens, G. Huisman-de Waal, and S. M. Zwakhalen, “A multicenter trial-based economic evaluation of the SELF-program: A function-focused care program for nursing staff providing long-term care for geriatric clients in nursing homes compared to care as usual,” PLoS One, vol. 20, no. 7, Art. no. e0320649, 2025, doi: 10.1371/journal.pone.0320649.
S. Li, L. Zhang, and Y. Fang, “Does social support alleviate the caregiving burden of adult children? Evidence from Chinese Long-Term care insurance pilot program,” Journal of Aging & Social Policy, vol. 37, no. 3, pp. 359-374, 2025, doi: 10.1080/08959420.2024.2384178.
L. Wang and J. Liu, “The impact of long-term care insurance on family care for older adults: The mediating role of intergenerational financial support,” Plos one, vol. 19, no. 5, Art. no. e0299974, 2024, doi: 10.1371/journal.pone.0299974.
Y. M. Cho and S. Kwon, “Effects of public long-term care insurance on the medical service use by older people in South Korea,” Health Economics, Policy and Law, vol. 18, no. 2, pp. 154-171, 2023, doi: 10.1017/s174413312200024x.
A. Wu, H. Jia, and L. Yang, “Impact of Long-Term Care Insurance on Institutional Care Admission Among Older Chinese Adults: Evidence from China Health and Retirement Longitudinal Study,” Journal of Aging & Social Policy, pp. 1-21, 2026, doi: 10.1080/08959420.2026.2560101.
W. He and H. Liu, “The system effect and group benefit equity of long-term care insurance from the perspective of short-term policy pilot,” Frontiers in Public Health, vol. 13, Art. no. 1580349, 2025, doi: 10.3389/fpubh.2025.1580349.
S. O. Han and H. Song, “Effect of Home-Visit Cognitive Function Training Among National Long-Term Care Insurance Beneficiaries With Dementia in Korea,” Journal of Gerontological Nursing, pp. 1-8, 2026, doi: 10.3928/00989134-202601220-00001.
Y. Chon, S. H. Lee, and Y. Y. Kim, “Long-term care insurance for older adults in terms of community care in South Korea: using the framework method,” Healthcare, vol. 12, no. 13, pp. 1238, 2024, doi: 10.3390/healthcare12131238.
B. Díaz Díaz, R. García-Ramos, C. López Gutiérrez, and A. Pérez, “Dependency and elderly care: the cost of the Long-Term care system in the context of the SDGs,” Sustainability, vol. 15, no. 21, Art. no. 15674, 2023, doi: 10.3390/su152115674.
M. Kitamura, J. Umeo, K. Kurihara, T. Yamato, T. Nagasaki, K. Mizota, and T. Yoshizawa, “Differences in improvement of physical function in older adults with long-term care insurance with and without falls: A retrospective cohort study,” Healthcare, vol. 11, no. 18, pp. 2558, 2023, doi: 10.3390/healthcare11182558.
M. Raj, M. Oleschuk, K. Chapman-Novakofski, and S. K. Levine, “Perceived Facilitators and Barriers to Implementing Culturally Inclusive Diets into Hospitals and Long-Term Care Facilities,” Journal of the American Medical Directors Association, vol. 24, no. 10, pp. 1503-1507, 2023, doi: 10.1016/j.jamda.2023.04.018.
S. Mežnarec-Novosel, M. Bogataj, D. Bogataj, and E. Drobež, “Effectiveness of New Reactivation Approaches in Integrated Long-Term Care—Contribution to the Long-Term Care Act,” Healthcare, vol. 13, no. 10, pp. 1187, 2025, doi: 10.3390/healthcare13101187.
M. Miller, J. Poss, J. Killingbeck, A. Sweetman, and A. P. Costa, “The OnSPARK data platform: a sector-governed infrastructure for workforce data for planning and quality improvement in long-term care,” Healthcare Management Forum, vol. 38, no. 1_suppl, pp. S28-S34, 2025, doi: 10.1177/08404704251363911.
M. Osińska, C. Meyer-Massetti, N. Welte, and F. Zúñiga, “Difficulties measuring a polypharmacy quality indicator in Switzerland’s residential long-term care institutions-a mixed-methods study,” Geriatric Nursing, vol. 68, Art. no. 103861, 2026, doi: 10.1016/j.gerinurse.2026.103861.
A. Szczepura, H. Masaki, D. Wild, T. Nomura, M. Collinson, and R. Kneafsey, “Integrated long-term care ‘neighbourhoods’ to support older populations: Evolving strategies in Japan and England,” International journal of environmental research and public health, vol. 20, no. 14, pp. 6352, 2023, doi: 10.3390/ijerph20146352.
D. K. Toprak and B. ¸Sahin, “Evaluation of long-term care services in Turkey from the perspectives of primary stakeholders,” Geriatric Nursing, vol. 64, Art. no. 103437, 2025, doi: 10.1016/j.gerinurse.2025.103437.
R. M. Werner, A. K. Hoffman, and R. T. Konetzka, “The Evolution of Long-Term Care and Health Policy in the United States,” Journal of Health Politics, Policy and Law, vol. 50, no. 6, pp. 1037-1058, 2025, doi: 10.1215/03616878-11995144.
Q. Ma, J. Ning, and H. Chen, “Changes of filial responsibility norms under public long-term care insurance in China,” Geriatrics & Gerontology International, vol. 25, no. 4, pp. 606-619, 2025, doi: 10.1111/ggi.13699.
S. Singh, C. D. Furman, L. A. Flint, and J. Teno, “Rehab and Death: Improving End‐Of‐Life Care for Medicare Skilled Nursing Facility Beneficiaries,” Journal of the American Geriatrics Society, vol. 74, no. 1, pp. 26-32, 2026, doi: 10.1111/jgs.70067.
J. Scattarelli, K. Moeller, D. Urbanski, and M. DeLiema, “Perspectives on the challenges of planning for and accessing long-term dementia care services through Medicaid and Medicaid waivers,” Jour- nal of Applied Gerontology, vol. 45, no. 2, pp. 332-341, 2026, doi: 10.1177/07334648251333181.
C. Yang, J. Huang, and J. Yu, “Inequalities in resource distribution and healthcare service utilization of long-term care in China,” International journal of environmental research and public health, vol. 20, no. 4, pp. 3459, 2023, doi: 10.3390/ijerph20043459.
Centers for Medicare & Medicaid Services, “(2025),” Nursing Home Compare [Data set]. Kaggle. https://www.kaggle.com/datasets/medicare/nursing-home-compare, pp. 6, 2003.