How Do We Know How Much We Need? Problems in Determining Need for Long-Term Care

As one solution to the widely perceived “crisis” in the long-term-care system, state and local agencies have developed methodologies which specify the amount and type of long-term-care services needed in an area. This article focuses on need-based methodologies, and criticizes the use of such formulae as a primary strategy to restructure the long-term-care system. The major weaknesses of this type of methodology are discussed, including faulty assumptions, lack of sufficient data, and the political character of the implementation process.