The need for long-term care (LTC) is projected to increase in all European countries due to the ageing of the population. The number of people aged 65 and older will double in EU-15 countries by 2050 under a pure ageing scenario and will increase by more than 30 per cent under the constant disability scenario. The aim of this paper is to see how different individual characteristics and the LTC systems around Western Europe influence the utilisation of formal LTC (in terms of frequency of services received). The data used from this study come from the Survey of Health Ageing and Retirement in Europe (SHARE) 2004-2005. We test here the individuals and systems characteristics determining the influence of use professional home-based LTC service (nursing care, domestic home assistance and meals-on-wheals). The frequencies are modelled using a negative binomial regression model. Our findings indicate that utilisation of professional home-based LTC increases significantly with factors like age, education, income and ADL (Activities of Daily Living) score. We found that the utilisation of LTC services is closely linked to the policy priorities, the financing and the organisations of the LTC system. In countries like the Netherlands, where a greater policy emphasis is put on home-based care, the utilisation of home-based LTC is higher compared with most of the other countries in the study.

Family policies have traditionally been weak in Southern Europe. In the last two decades,\ud however, and following a ‘catching up’ course, Spain has created new family programmes\ud and expanded existing ones. Meanwhile, the picture for Italy during the years preceding\ud the crisis is more of a ‘frozen landscape’. However, the diverging paths of the two countries\ud in terms of policy reform in the years preceding the crisis do not place them in\ud substantially different positions. The economic crisis and the austerity measures that\ud followed have aggravated the weaknesses of family and care policies in both countries

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This article makes a comparative analysis of the trajectories of welfare change in Italy and Spain since the outbreak of the financial crisis. We look at the differences in the types of institutional design to study of welfare reform in these two countries and assess how recent changes have affected welfare state institutions. The article also assesses the level of EU involvement not only through formal instruments around the European Semester, but also by means of agreements with the Troika and the European Central Bank. For this part of the analysis three sets of documents have been used: Commission Recommendations and Council Decisions in relation to Excessive Deficit Procedures; Commission country-specific recommendations based on Stability or Convergence Programmes; and Policy Measures to boost growth and jobs (National Reform Programmes). These documents allow an analysis of the contents of formal adjustment pressures. Other documents and sources (including newspaper articles) have also been analysed in order to look at the role of conditionality and 'backroom' diplomacy.

This article explores changes that took place in long-term care (LTC) policies during the last two decades\ud in six European welfare states. In this regard, it addresses three issues: (1) why reforms took place, (2) the\ud main actors and coalitions driving this process and the institutional mechanisms at work and (3) the main\ud outcomes of reform processes. In order to analyse the development of LTC policies, the article applies\ud theoretical concepts of historical institutionalism. Our interpretation is that institutional change in LTC\ud policy has taken place through a protracted institutional dynamic in which continuity and discontinuity\ud are inextricably linked and where tensions and contradictions have played a crucial role. With regard to\ud outcomes, the article analyses coverage and citizens’ social rights, working conditions in the care sector\ud and trajectories of de-/re-familization of care. The final impact is that the level of universalism has generally\ud increased in Europe, but that in part it has adopted a new form of ‘restricted universalism’, characterized\ud by universal entitlements to LTC benefits constrained by limitations in provision due to financial constraints\ud and budget ceilings