Long-term care in the health system: European tendencies and Bulgarian experience

Abstract

Introduction: One of the most serious challenges faced by health systems in the world is the population ageing, which stresses the increasing importance of long-term care. This article aims at providing a concise definition of long-term care, the kinds of services included in it, the trends in the long-term care costs and the scope of the services, as well as the various financial arrangements for long-term care. Materials and methods: This is a review article, which summarizes the findings in the literature concerning the content and scope of the concept „long-term care`. An attempt has been made to give a short classification of the types of long-term care services and their financing. The paper is based on materials, analyses and statistical data by the Organization of Economic Cooperation and Development (OECD), the European Union and Bulgarian sources. Results and Discussion: The term „long-term care` refers to a range of services provided for people with limited ability (physical and/or mental) to function who therefore depend on an outside assistance for meeting various needs (medical and nonmedical) for an extended period providers. The share of long-term care health costs in GDP and in total health costs varies significantly across the EU member-states. It is substantially lower in the new Central and Eastern European members, among which Bulgaria ranks last. EU countries can be grouped on different dimensions to deliver a typology of long-term care systems, some of the classifications being presented in the article. Conclusion: The long-term care system faces a number of challenges, connected with the increasing costs parallel with the rising expectations for a higher quality and efficiency. A challenge in every country, even the most developed one, is the provision of the adequate number and qualification mix of formal carers as well as various types of assistance for the informal carers - financial, information, consultative and psychological.