What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands

Alders, Peter; Costa‐Font, Joan; Klerk, Mirjam de; Frank, Richard G.

doi:10.1016/j.healthpol.2015.02.006

Cited by 30 publications

(41 citation statements)

References 21 publications

(20 reference statements)

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“…Although need factors would predict a higher rate of institutional use in Germany, in 2004 the percentage of people over 65 in institutions in the Netherlands was almost double the percentage in Germany (Alders et al 2015). Furthermore, the percentage of people over the age of 65 years, living in an institution dropped from 7.2 % in 2004 to 6.5 % in 2010 in the Netherlands.…”

Section: Introductionmentioning

confidence: 99%

“…Government policy and social norms have been suggested as important explanatory factors of the relatively high level of institutional care in the Netherlands, based on a comparison of the cases of the Netherlands and Germany (Alders et al 2015). In 1995, admission to an LTC institution became less expensive for people with assets as the government ceased means testing (Alders et al 2015).…”

Section: Introductionmentioning

confidence: 99%

“…In 1995, admission to an LTC institution became less expensive for people with assets as the government ceased means testing (Alders et al 2015). Personal budgets were introduced in 1995.…”

Section: Introductionmentioning

confidence: 99%

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Changes in admission to long-term care institutions in the Netherlands: comparing two cohorts over the period 1996–1999 and 2006–2009

2016

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Using data from two cohorts, we examine to what extent a decline in institutional care in the Netherlands is associated with changes in the need for care and/or societal factors. We compared older adults, aged 65–89, who were admitted to a long-term care (LTC) institution in the period 1996–1999 and 2006–2009. Using the Andersen model, we tested per block of predisposing, enabling and need factors, which factors were significant predictors of admission to institutional care. With a Blinder–Oaxaca decomposition regression, we decomposed the difference in admission to an LTC institution between the period 1996–1999 and 2006–2009 into a part that is due to differences in health needs and other factors such as effect of policy, social values, and technology. Between 1996 and 2006, the percentage of co-residing partners and income increased and the average level of loneliness decreased significantly. The prevalence of disability, chronic diseases, however, increased. Whereas the care by partners declined, the formal care by professionals increased. Although the observed decline in the admission rate to institutional care was relatively small across the 10 years (from 5.3 % in 1996–1999 to 4.5 % in 2006–2009, a 15 % decrease), the probability of admission in 2006–2009 was relatively much lower when accounting for changes in the health and social conditions of the participants: the probability was 1.7–2.1 % point lower for adults in the period 2006–2009 compared to 1996–1999, a 32–40 % decrease. Our results show that the decline in the admission rate to LTC institutions is not the result of changes in need. The decline is suggested to be the combined effect of changes in policy, technological advances and changes in social norms.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changes in admission to long-term care institutions in the Netherlands: comparing two cohorts over the period 1996–1999 and 2006–2009

2016

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“…The low quota of care not performed at home could be accounted for by a lower perceived quality of care in nursing homes as well as a lack of acceptance of nursing homes as the main care provider (Alders et al . ). Compared with other European countries, the European Network of Economic Policy Research Institutes reported the use of formal care in Germany to be the lowest.…”

Section: Discussionmentioning

confidence: 97%

Geospatial analysis and distribution patterns of home nursing care in a metropolitan area - a large-scale analysis

et al. 2016

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“…Several studies provide descriptive analyses to compare countries with an LTCI system, such as Germany, the Netherlands, South Korea, and Japan. Specifically, Campbell, Ikegami, and Gibson [9] described Japan and Germany; Alders, Costa-Font, de Klerk, and Frank [10] considered the Netherlands and Germany; and Rhee, Done, and…”

Section: First We Employ Regression Analyses In Which Explanatory Vamentioning

confidence: 99%

Comparison of Japanese and German nursing homes: Implications of demographic and policy differences

Karmann

Sugawara

2020

Preprint

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Background This research provides a comparative study of Japanese and German nursing homes. Although these two aging countries share similar long-term care policies based on social insurance, descriptive statistics show the existence of a large difference in the outcomes of their nursing home sectors. This research pursues the reason behind these observations, looking at demographic and policy differences between the two countries. Methods To shed light from multiple angles, we conduct empirical analysis using three methods: regression, the Blinder-Oaxaca decomposition, and data envelopment analysis using regional data from the past decade. Results Our empirical results find that different outcomes are driven by both demographic and policy differences.Conclusions The results from the demographic elements indicate that the process of ageing will have a severer consequence for Germany than for Japan when Germany would catch up with the age profile of Japan. Among the policy elements, our result is consistent to the existence of moral hazard in Germany due to a generous welfare program.

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What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands

Cited by 30 publications

References 21 publications

Changes in admission to long-term care institutions in the Netherlands: comparing two cohorts over the period 1996–1999 and 2006–2009

Changes in admission to long-term care institutions in the Netherlands: comparing two cohorts over the period 1996–1999 and 2006–2009

Geospatial analysis and distribution patterns of home nursing care in a metropolitan area - a large-scale analysis

Comparison of Japanese and German nursing homes: Implications of demographic and policy differences

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