Modelling an entitlement to long-term care services for older people in Europe: projections for long-term care expenditure to 2050

Abstract

As the numbers of older people rise in Europe, the importance of long-term care services in terms of numbers of users and expenditures can be expected to grow. This article examines the implications for expenditure in four countries of a national entitlement to long-tem care services for all older people, based on assessed dependency. It is based on a European Commission-funded crossnational study, which makes projections to 2050 of long-term care expenditure in Germany, Italy, Spain and the UK. The policy option investigated is based on the German long-term care insurance scheme, which embodies the principle of an entitlement on uniform national criteria to long-term care benefits. The research models this key principle of the German system in the other three participating countries, with respect to home care services. The study finds that, if all moderately/severely dependent older people receive an entitlement to formal (in-kind) home care, the impact on expenditure could be considerable, but would vary greatly between countries. The impact on long-term care expenditure is found to be the least in Germany, where there is already an entitlement to benefits; and the greatest in Spain, where reliance on informal care is widespread. This article discusses the policy implications of these results.

Formal home-care utilisation by older adults in Ireland: evidence from the Irish Longitudinal Study on Ageing (TILDA)

“…Disability defined by an ADL/IADL difficulty is often used to model expenditure on long‐term care without any recognition that those without a disability may also utilise the services available (Pickard et al . ). The research presented above suggests that a limited focus on ADL/IADL difficulties only may miss out on other important types of need.…”

Care by Spouses, Care by Children: Projections of Informal Care for Older People in England to 2031

“…The small impact of changes in the marital status projections on long-term care demand and expenditure does not, however, mean that other changes in informal care supply would not have a greater impact (Pickard et al, 2007). This relatively small impact arises because increases in spouse care seem primarily to reduce other forms of informal care.…”

Ambient Assisted Living for ageing well – an overview

“…Thus, by 2050 there will be 215.9% more in this age group. In various studies from (Pickard et al, 2007), (Ö sterle, Hammer, 2004), or (Badelt et al, 1996) it is forecasted that the number of people in the need of care will be increasing to approximately 810,000 by 2030. Following a study by Schaffenberger and Pochobradsky (Schaffenberger, Pochobradsky, 2004), Vienna is providing the highest accommodation, where 21 care persons are available for one thousand over 75-year-old people.…”