# Are long-term care systems aligned with person-centered integrated care? Evidence from the Western Pacific

## TL;DR

Western Pacific long-term care systems lack full integration with healthcare, hindering effective aging in place.

## Contribution

This study evaluates LTC policy alignment with integrated care principles in five Western Pacific countries.

## Key findings

- Fragmentation between LTC and healthcare is common due to misaligned incentives and poor coordination.
- All five countries offer LTC services but lack key enablers like integrated financing and data systems.
- Policy reforms are needed to strengthen accountability and performance management in LTC systems.

## Abstract

•Western Pacific LTC systems are not fully aligned with effective integrated LTC.•Key system enablers fostering accountability for integrated care remain limited.•Policy reforms should prioritize shared accountability, aligned financing, and data systems.

Western Pacific LTC systems are not fully aligned with effective integrated LTC.

Key system enablers fostering accountability for integrated care remain limited.

Policy reforms should prioritize shared accountability, aligned financing, and data systems.

Many Western Pacific countries have established long-term care (LTC) systems to support their rapidly aging populations. However, the extent to which these systems align with integrated care principles that enable individuals to age in place (AIP) remains unclear. Effective integration of LTC with healthcare is essential to enhance continuity of care, improve outcomes, and support AIP.

This study examines the alignment of LTC policies in five Western Pacific countries—Australia, Japan, New Zealand, Republic of Korea, and Singapore—with integrated LTC principles. The analysis identifies systemic enablers and challenges in governance, financing, workforce, service delivery, information, monitoring & evaluation (IM&E), and innovation & research.

Using an adapted World Health Organization LTC framework, we conducted a comparative analysis of the selected countries’ LTC policies.

All five countries emphasize aging in place and provide both institutional and community-based LTC services. However, key enablers of integration are often lacking. Fragmentation between LTC and healthcare is common, and coordination mechanisms such as care planning are hindered by inadequate accountability mechanisms due to misaligned incentives, challenges in funding integration, and often underdeveloped information systems for monitoring integrated care.

Western Pacific LTC systems are not yet fully aligned with effective integrated LTC. Strengthening coordinated and accountable governance, integrating financing streams and incentive, enhancing IM&E systems for performance management, and leveraging innovation are crucial to enhancing integrated LTC in the region.