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Open Access 01-12-2011 | Research article

Patterns of Long Term Care in 29 European countries: evidence from an exploratory study

Authors: Gianfranco Damiani, Valentina Farelli, Angela Anselmi, Lorella Sicuro, Alessandro Solipaca, Alessandra Burgio, Domenica Fioredistella Iezzi, Walter Ricciardi

Published in: BMC Health Services Research | Issue 1/2011

Abstract

Background

The challenges posed by the rapidly ageing population, and the increased preponderance of disabled people in this group, coupled with the rising level of public expenditure required to service the complex organization of long term care (LTC) delivery are causing increased pressure on LTC systems in Europe. A pan-European survey was carried out to evaluate whether patterns of LTC can be identified across Europe and what are the trends of the countries along them.

Methods

An ecological study was conducted on the 27 EU Member States plus Norway and Iceland, referring to the period 2003-2007. Several variables related to organizational features, elderly needs and expenditure were drawn from OECD Health Data and the Eurostat Statistics database and combined using Multiple Factor Analysis (MFA).

Results

Two global Principal Components were taken into consideration given that their expressed total variance was greater than 60%. They were interpreted according to the higher (more than 0.5) positive or negative correlation coefficients between them and the original variables; thus patterns of LTC were identified. High alignment between old age related expenditure and elderly needs characterizes Nordic and Western European countries, the former also having a higher level of formal care than the latter. Mediterranean as well as Central and South Eastern European countries show lower alignment between old age related expenditure and elderly needs, coupled with a level of provision of formal care that is around or slightly above the average European level. In the dynamic comparison, linear, stable or unclear trends were shown for the studied countries.

Conclusions

The analysis carried out is an explorative and descriptive study, which is an attempt to reveal patterns and trends of LTC in Europe, allowing comparisons between countries. It also stimulates further researches with lower aggregated data useful to gain meaningful policy-making evidence.

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Available only for authorised users

Organization for Economic Cooperation and Development: Long term care for elderly people. Paris. 2005, [http://www.OECD.org]

Commission of the European Communities: The demographic future of Europe - from challenge to opportunity. Brussels. 2006, [http://europa.eu/legislation_summaries/employment_and_social_policy/situation_in_europe/c10160_en.htm]

European Commission, Economic and Financial Affairs DG: The 2009 Ageing Report: economic and budgetary projections for the EU-27 Member States (2008-2060). Luxembourg. 2009, [http://ec.europa.eu/economy_finance/publications/publication_summary14911_en.htm]

Lafortune G, Balestat G: Trends in severe disability among elderly people: assessing the evidence in 12 OECD countries and the future implications [Organization for Economic Cooperation and Development, Health Working Paper no. 26]. Paris. 2007, [http://www.oecd.org/document/25/0,3343,en_2649_33929_2380441_1_1_1_1,00.html]CrossRef

Hoxley H: Policies for healthy ageing: an overview [Organization for Economic Cooperation and Development, Health Working Paper no. 42]. Paris. 2009, [http://www.oecd.org/document/25/0,3343,en_2649_33929_2380441_1_1_1_1,00.html]

Oliveira Martins J: Projecting OECD health and long term care expenditures: What are the main drivers? [Organization for Economic Cooperation and Development. Economics Department Working Paper no. 477]. Paris. 2006, [http://www.oecd.org/LongAbstract/0,3425,en_2649_34113_36085941_1_1_1_1,00.html]

European Commission, Social Affairs and Equal Opportunities DG: Long Term Care in the European Union. 2008, [http://ec.europa.eu/employment_social/news/2008/apr/long_term_care_en.pdf]

OECD Health Data. 2009, [http://www.OECD.org]

Eurostat Statistics. [http://epp.eurostat.ec.europa.eu/portal/page/portal/eurostat/home/]

10.

Escofier B, Pagès J: Multiple factor analysis. Computational Statistics & Data Analysis. 1990, 18: 121-140.CrossRef

11.

Petigas P, Poulard JC: A multivariate indicator to monitor changes in spatial patterns of age-structured fish populations. Aquat Living Resour. 2009, 22: 165-171. 10.1051/alr/2009018.CrossRef

12.

Abdi H, Valentin D: Multiple Factor Analysis (MFA). Encyclopedia of measurement and statistics. Edited by: Salkind N. 2007, 1-14.

13.

Stanimirova I, Walczak B, Massart DL: Multiple factor analysis in environmental chemistry. Analytica Chimica Acta. 2005, 545: 1-12. 10.1016/j.aca.2005.04.054.CrossRef

14.

Mazouni N, Gaertner JC, Deslous Papli JM: Composition of biofouling communities on suspended oyster coltures: an in situ study on interaction with the water column. Marine Ecology Progress Series. 2001, 214: 93-102.CrossRef

15.

Wong S, Gauvrit H, Cheaib N, Carré F, Carrault G: Multiple factor analysis as a tool for studying the effect of physical training on the autonomic nervous system. Computers in Cardiology. 2002, 29: 437-440.CrossRef

16.

Ainleya DG, Speara LB, Tynanb CT, Barthc JA, Piercec SD, Fordd RG, Cowlesc TJ: Physical and biological variables affecting seabird distributions during the upwelling season of the northern California Current. Deep-Sea Research. 2005, 52: 123-143.CrossRef

17.

Petitgas P, Poulard JC: Multi-factorial Analysis (MFA) and Spatial Indicators. 2004, Fisboat: fisheries independent survey-based operational assessment tools. Nantes, 129-132.

18.

Porcu R: Servizi sanitari, popolazione e mobilità sanitaria della Sardegna: un'analisi multiway. (Health care services, population and health care mobility in Sardinia: a multiway analysis). Difesa Sociale LXXXVI. 2007, 57-74. 3

19.

American Association for Retired Persons Public Policy Institute: European experience with Long Term Care. France, the Netherlands, Norway and the United Kingdom. 2006, [http://www.aarp.org/research/international/report/leadershipstudyreports.html]

20.

Schulz E: The long term care system in Denmark. [European Network of Economic Policy Research Institute, Research Report no. 73]. 2010, DIW Berlin (Deutsches Institut fuer Wirtschaftforschung, [http://www.ancien-longtermcare.eu/node/27]

21.

Fernandez JL, Forder J, Trukeschits B, Rokosaova M, McDaid D: How can European states design efficient, equitable and sustainable funding systems for long term care for older people?. 2009, World Health Organization, Regional Office for Europe and European Observatory on Health Systems and Policies

22.

Da Roit B, Le Bihan B: Similar and yet so different: cash-for-care in six European countries' long-term care policies. The Milbank Quarterly. 2010, 88 (3): 286-309. 10.1111/j.1468-0009.2010.00601.x.CrossRefPubMedPubMedCentral

23.

Da Roit B, Le Bihan B, Österle A: Long-term care policies in Italy, Austria and France: variations in cash-for-care schemes. Social policy and administration. 2007, 41: 653-671. 10.1111/j.1467-9515.2007.00577.x.CrossRef

24.

Bolin K, Lindgren B, Lundborg P: Informal and formal care among single living elderly in Europe. Health Economics. 2008, 17 (3): 393-409. 10.1002/hec.1275.CrossRefPubMed

25.

Gibson MJ, Gregory SR, Pandya SM: Long Term Care in developed nations: a brief overview. 2003, AARP Public Policy Institute, [http://www.uncioa.org/agelib/record.asp?RecordID=3035]

26.

Garcés J, Ròdenas F, Sanjosé V: Towards a new welfare state: the social sustainability principle and health care strategies. Health Policy. 2003, 65: 201-215. 10.1016/S0168-8510(02)00200-2.CrossRefPubMed

27.

Rechel B, Doyle Y, Grundy E, McKee M: How can health systems respond to population ageing? World Health Organization, Regional Office for Europe and European Observatory on Health Systems and Policies. 2009

28.

Costa-Font J: Devolution, diversity and welfare reform: Long-term care in the 'Latin Rim'. Social Policy Administration. 2010, 44 (4): 481-494. 10.1111/j.1467-9515.2010.00724.x.CrossRef

29.

Damiani G, Colosimo S, Sicuro L, Burgio A, Battisti A, Solipaca A, Baldassarre G, Crialesi R, Milan G, Tamburrano T, Ricciardi W: An ecological study on the relationship between supply of beds in long-term care institutions in Italy and potential care needs for the elderly. BMC Health Services Research. 2009, 9: 174-186. 10.1186/1472-6963-9-174.CrossRefPubMedPubMedCentral

30.

Österle A: Long-term Care in Central and South-Eastern Europe: challenges and perspectives in addressing a 'new' Social Risk. Social Policy & Administration. 2010, 44 (4): 461-480. 10.1111/j.1467-9515.2010.00723.x.CrossRef

31.

First Results from the Survey of Health, Ageing and Retirement. Edited by: Axel Börsch-Supan et al. 2008, Mannheim Research Institute for the Economics of Aging (MEA)

32.

Hofstede G: Culture's consequences: comparing values, behaviors, institutions, and organizations across nations. 2001, Thousand Oaks, CA: Sage, 2

33.

Veenhoven R: Freedom and happiness. A comparative study in 46 nations in early 1990s. Edited by: Diener E, Suh EM. 2000, 'Culture and subjective wellbeing' MIT press, Cambridge, MA USA

34.

Dunteman GH: Principal Component Analysis. 1989, SAGE PublicationsCrossRef

35.

Suhr DD: Principal Component Analysis vs. Exploratory Factor Analysis, Paper 203-30.

36.

Burwell B, Jackson B: The disabled elderly and their use of long-term care. 1994, [http://www.aspe.hhs.gov]

37.

Colombo F: The long term care workforce: overview and strategies to adapt supply to a growing demand [Organization for Economic Cooperation and Development, Health Working Papers no.44]. Paris. 2009, [http://www.oecd.org/LongAbstract/0,3425,en_2649_34113_36085941_1_1_1_1,00.html]

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/11/316/prepub

Title: Patterns of Long Term Care in 29 European countries: evidence from an exploratory study
Authors: Gianfranco Damiani
Valentina Farelli
Angela Anselmi
Lorella Sicuro
Alessandro Solipaca
Alessandra Burgio
Domenica Fioredistella Iezzi
Walter Ricciardi
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2011
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/1472-6963-11-316

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Patterns of Long Term Care in 29 European countries: evidence from an exploratory study

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

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Abstract

Background

Methods

Results

Conclusions

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