ANCIEN Overview of ANCIEN and classification of long-term care systems Esther Mot (Netherlands...
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ANCIEN Overview of ANCIEN and classification of long-term care systems Esther Mot (Netherlands Bureau for Economic Policy Analysis, CPB), Peter Willemé (Federal Planning Bureau) iHEA, 8th World Congress on Health Economics, Toronto, July 10-13 2011
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ANCIENOverview of ANCIEN and classification of long-term care systems
Esther Mot (Netherlands Bureau for Economic Policy Analysis, CPB), Peter Willemé (Federal Planning Bureau)
iHEA, 8th World Congress on Health Economics, Toronto, July 10-13 2011
Long-term care for the elderly
ANCIEN, general information
Assessing Needs of Care in European Nations
research for EC in 7th Framework Programme
January 2009 – August 2012
21 EU-countries included
Typologies of LTC systems
Results of Work package 1
managed by Institute for Advanced Studies, Vienna
typology report:Kraus, M., M. Riedel, E. Mot, P. Willemé, G. Röhrling, T. Czypionka (2010), A typology of systems of Long-Term Care in Europe
ANCIEN, objectives describe and characterise systems of LTC in
Europe
analyse the need for care (in relation to demography and lifestyle)
analyse developments in the supply and demand for formal and informal care
analyse the potential role of technology in solving LTC problems
ANCIEN, objectives continued analyse efforts to improve the quality of
LTC
project the use of LTC on the basis of developments in need and supply
evaluate the performance of different types of LTC systems
Aims of Work Package 1
description of LTC-systems in Europe
development of typologies designed for analysis of LTC systems (as opposed to more
general welfare state typologies)
selection of countries to model needs (demography, lifestyle) supply (formal and informal) use of care
WP1, steps data on LTC collected by national experts
standardised format problems with data collection
country reports
typologies
Characteristics for typologyWho carries the most responsibility for LTC:
formal system or family/person?:
public spending on LTC private spending on LTC role of formal versus informal care support for informal care givers is there an entitlement? how strict are eligibility criteria?
Characteristics for typology, 2 How is formal system organised:
quality assurance type of providers centralised or not? coordination and integration of care
What about freedom of choice? role of cash benefits? free choice of providers?
WP1, two methods of clustering
mostly organisational, 21 countries for example choice of provider, quality
assurance
use and financing of care, 14 countries
Use and financing typology selection of 8 metric variables for 14
countries
factor analysis on 8 variables, 4 variables used
cluster-analysis
Variables public spending* (related to GDP and needs)
share of private expenditures* informal care use* IC support* formal care use role of cash benefits accessibility targeting
Result
Result, by clusterinformal care oriented, low private financing
Belgium*, Czech Republic, Germany, Slovakia* medium spender
low spending, low private, high IC use, high IC support,cash benefits modest
generous, accessible and formalized
Denmark, the Netherlands, Sweden
high spending, low private, low IC use, high IC support,cash benefits modest
informal care oriented, high private financing
Austria, England, Finland, France, Spain
medium spending, high private, high IC use, high IC support,cash benefits high
high private financing, informal care seems necessity
Hungary, Italy
low spending, high private, high IC use, low IC support,cash benefits medium
Star plot of LTC systems
Countries to be modelled (considering data availability) Germany
the Netherlands
Spain
Poland (simplified models)
Conclusion most new member states only to be
analysed with organisational approach, but NMS not in 1 cluster (in both typologies)
3 variables crucial for countries with better data: needs-corrected public spending, private
funding, informal care support
Conclusion 2 stable clustering of Nordic countries with
generous systems with large role for formal care (under different approaches): Sweden, Denmark, Netherlands
important role for informal care in all other clusters distinction by private financing, IC support, use
of formal care, role of cash benefits
Conclusion 3
large impact of available information
different clustering with richer dataset clustering especially for LTC is different
More information:
http://www.ancien-longtermcare.eu/ general information country reports on LTC systems typology report
[email protected] (Institute for Advanced Studies) [email protected] (CPB) [email protected] (FPB)
