Abstract
We propose a fuzzy approach to quantify a cash-benefit for older people in need of Long-Term Care, e.g., affected by limitations in daily-living activities. Many approaches exist at national or regional level in Europe, and most legislation determine eligibility to public care-programs using rule-based approaches which aggregate basic health-outcomes into main pillars and then into eligibility categories. Population ageing and improvements in longevity make access to care a crucial problem for Western economies. In this paper we focus on Italy, where public-care eligibility is decentralized at regional level and often based on check-lists, and in particular on the Toscana region. We investigate the extent to which the existing legislation violates basic properties of monotonicity and continuity, thus potentially increasing inequity in care access. We then propose the introduction of a fuzzy approach to the eligibility determination, which allows for smoother results and reduced inequality.
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Notes
- 1.
Formal-care includes all care services that are provided in the context of formal regulations, such as through contracted services, mostly by trained care workers, that can be paid out of pocket or through reimbursement by public (or, less often, by private) institutions. What characterizes formal care-provision is its acknowledgment by the Social or Health departments at the proper governmental level. Informal-care is, conversely, a term that refers to the unpaid assistance provided by partners, adult children and other relatives, friends or neighbors who hold a significant personal relationship with the care recipient.
- 2.
A nation-wide cash benefit, the Indennità di Accompagnamento (IA), is available to individuals classified as invalid. Yet, there is no nationwide guideline as to how to assess and evaluate such outcome.
- 3.
See, e.g., the regulation of the Casentino district, at http://www.uc.casentino.toscana.it/regolamenti/disposizioni-attuative-anno-2013.pdf.
- 4.
The UVM can, in principle, decide to allow some benefit for individuals in groups 1 and 2 (Regional law D.G.R. n.370, Attachment A).
- 5.
The exact monetary value of the benefit in each cell needs to be determined by the Public Authority. This phase will would require participatory decision methods (focus group, brainstorming, questionnaires). In this paper, the values allocated to each cell are purely indicative.
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Carrino, L., Giove, S. (2021). A Fuzzy Approach to Long-Term Care Benefit Eligibility; an Italian Case-Study. In: Esposito, A., Faundez-Zanuy, M., Morabito, F., Pasero, E. (eds) Progresses in Artificial Intelligence and Neural Systems. Smart Innovation, Systems and Technologies, vol 184. Springer, Singapore. https://doi.org/10.1007/978-981-15-5093-5_29
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