Forms of Providing and Financing Long-Term Care in OECD Countries

Abstract Long-term care is being prioritised due to population ageing, and hand in hand with the development of professional provision of long-term care, public expendi-tures will be increasing. Mainly countries with a sharp increase in the number of people aged 80+ will have to address the sustainability of long-term care systems and the pro-curement of relevant services. This paper aims to evaluate the forms of provision and financing of long-term care in selected OECD countries. Provision and funding of long-term care in terms of a formal system are assessed based on selected criteria using analytical methods (principal component analysis and TwoStep cluster analysis). Results of the evaluation carried out in 2008 and 2013 by means of the selected indicators of long-term care, using TwoStep cluster analysis, confirmed both similar as well as different approaches to the provision and financing of long-term care in the analysed countries. The most marked differences in the provision of care based on indicators LTC recipients aged 65+ and LTC recipients in institutions as a percentage of total LTC recipients were found between the first cluster (Australia and Korea with the highest share of LTC recipients) and the second cluster (Czech Republic, Estonia, with the lowest share of LTC recipients). In financing of long-term care (LTC expenditures on institutions as a percentage of total LTC expenditures), the most significant differences were observed between the first (Australia, Korea, with the largest share of LTC expenditures on institutions) and third cluster (mainly Nordic countries, with the lowest share of LTC expenditures on institutions of total LTC expenditures).

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Health and Care of an Ageing Population: Alignment of Health and Social Systems to Address the Need

Journal of Health Management ◽

10.1177/0972063421994992 ◽

2021 ◽

pp. 097206342199499

Author(s):

Sangay Thinley

Keyword(s):

Health Care ◽

Older People ◽

Long Term Care ◽

Health Care Systems ◽

Population Ageing ◽

Demographic Shift ◽

Term Care ◽

The Social ◽

Care Systems

Population ageing is both an achievement and challenge, an achievement as longevity is the result of successful prevention and control of diseases, decreasing fertility rates and overall socio-economic development. It is at the same time a challenge as the increasing number of older people and the resultant demographic shift are accompanied by the need to adjust and scale up the social and health care systems. The challenges are of particular relevance to the developing world where the demographic shift is occurring much faster. Comprehensive efforts based on country contexts are required in the following areas: (a) older persons and development, (b) health and well-being and (c) enabling and supportive environments to address population ageing needs. This article, however, focuses only on three most crucial issues, that is, livelihood, health care systems and care of the older dependent people. Measures to sustain the livelihood of older people, to align the health systems to provide care and to develop long-term care systems are highlighted. Person-centred care, integration and functional capacity are advocated. Further, ageing in place or living in one’s own home, community or a place with the closest fit with the person’s needs and preferences is considered very important for healthy ageing. In terms of enhancing livelihood, major policy changes and reforms to improve the social security systems and expanding coverage as well as increasing the amounts to minimum subsistence levels are highlighted. Another area which needs to be strengthened is the tradition of existing family support systems. The health systems alignment required are reflected for each health system building block, and focuses mainly on (a) developing and ensuring access to services that provide older-person-centred care; (b) shifting the clinical focus from disease to intrinsic capacity; and (c) developing or reorienting the health workforce to provide care as per alignment. Long-term care systems would best meet the needs of dependent older people if families, communities, civil society organisations and private sector are equally involved while governments play leadership roles in setting up and monitoring quality.

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Subacute care and rehabilitation

Australian Health Review ◽

10.1071/ah020140 ◽

2002 ◽

Vol 25 (5) ◽

pp. 140 ◽

Cited By ~ 5

Author(s):

Len Gray

Keyword(s):

Chronic Disease ◽

Long Term Care ◽

Population Ageing ◽

Rehabilitation Services ◽

Term Care ◽

Subacute Care ◽

Reporting Systems ◽

Care Systems

Subacute and rehabilitation services are likely to play an increasingly important role in the health and long-term care systems, as population ageing increases the prevalence of chronic disease and disability. The role and scope of these services is difficult to assess in the Australian context due to the paucity of standardised definitions and administrative reporting systems. This paper appraises the role of these services and reflects on principles and evidence that might underpin their future development.

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Long-term care reforms in OECD countries

10.2307/j.ctt1t88zbz ◽

2015 ◽

Keyword(s):

Long Term Care ◽

Oecd Countries ◽

Term Care

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Informal carer in Portugal: moving towards political recognition in Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckz187.178 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

I Fronteira ◽

J Simoes ◽

G Augusto

Keyword(s):

Informal Care ◽

Long Term Care ◽

Well Being ◽

Oecd Countries ◽

Low Fertility ◽

Informal Carer ◽

Term Care ◽

System Perspective ◽

Informal Carers

Abstract Informal care represents around 80% of all long term care provided in EU countries. Nevertheless, the needs for this type of care are expected to increase in the coming years in all OECD countries. Portugal is among the OECD countries with the highest ageing index (21.5% of the population was older than 65 years in 2017) due to high life expectancy and low fertility rates. As this demographic trend establishes, Portugal is expected to have more than 40% of the population over 65 years in 2037, and the expected prevalence of dementia is 3%, in 2050. In 2015 there were 2.1% of people over 65 receiving long-term care, representing 52% of all long-term care users. Around 38% were receiving care at home. It is estimated that 287,000 people in Portugal depend on informal carers. The agenda towards the official recognition of informal cares has been push forward in the country. Since 2015, several recommendations have been issued by the Parliament as well as legislative initiatives and a proposal for a Status of the Informal Carer is currently under discussion. We analyse the process of formulation of this policy in terms of sectors and stakeholders involved, definition and scope of informal carer, rights and obligations, role of the person being cared for, formal protection (e.g., labor, social, financial, training) and implementation. Recognition of the informal carer is a sector wide approach. One of the main features is the economic, social and labor protection mainly through reconciliation between work life and caring activities and promotion of the carer’s well being. Notwithstanding, and from a health system perspective, community health teams are to be the focal point for informal carers, supporting and providing specific training whenever needed. Despite its relevance, informal care should not be professionalized and responsibility of care should not be shifted from health services to informal carers. Key messages Needs for informal care are expected to increase in the coming years in OECD countries. Recognition of the informal carer is a sector wide approach.

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Impacts of Informal Caregiver Availability on Long-term Care Expenditures in OECD Countries

Health Services Research ◽

10.1111/j.1475-6773.2004.00328.x ◽

2004 ◽

Vol 39 (6p2) ◽

pp. 1971-1992 ◽

Cited By ~ 22

Author(s):

Byung-Kwang Yoo ◽

Jay Bhattacharya ◽

Kathryn M. McDonald ◽

Alan M. Garber

Keyword(s):

Long Term Care ◽

Informal Caregiver ◽

Oecd Countries ◽

Term Care

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Worlds of long-term care: A typology of OECD countries

Health Policy ◽

10.1016/j.healthpol.2021.02.009 ◽

2021 ◽

Author(s):

Mareike Ariaans ◽

Philipp Linden ◽

Claus Wendt

Keyword(s):

Long Term Care ◽

Oecd Countries ◽

Term Care

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Pflegebedürftigkeit unterscheiden

10.5771/9783748923749 ◽

2021 ◽

Author(s):

Johannes Michael Bergmann

Keyword(s):

Cluster Analysis ◽

Long Term Care ◽

Multiple Correspondence Analysis ◽

Methodological Approach ◽

Assessment System ◽

Theoretical Discussion ◽

Need For Care ◽

Term Care ◽

Measurement And Analysis

In Germany, a new assessment system (the NBA) is being applied to assess the need for long-term care. The degree of care that is calculated defines the extent of welfare state benefits. Measuring and analysing the need for care in a statistically appropriate way is subject to certain preconditions. This book presents multiple correspondence analysis (MCA) in combination with cluster analysis (HCA) as an innovative methodological approach to dealing with this challenge. The first part provides a theoretical discussion of the need for care; the second part describes MCA and HCA in detail using an example. The book is aimed at all those involved in the measurement and analysis of the need for care.

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