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

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

doi:10.1186/1472-6963-11-316

Abstract

BackgroundThe 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.MethodsAn 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).ResultsTwo 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.ConclusionsThe 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.Please see related article: http://www.biomedcentral.com/1741-7015/9/124

Highlights

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
The Organization for Economic Cooperation and Development (OECD) defines LTC as “a range of services needed for persons who are dependent on help with basic activities of daily living over an extended period of time” [1]
The second Principal Component (PC) was mainly negatively determined by the variables of LTC beds in institutions and recipients at home

Summary

Introduction

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. Demographic trends, financial issues and organizational features are the factors that mainly affect current policies of long term care (LTC) in Europe. The number of elderly will almost double in the near future, rising from 85 million in 2008 to 151 million in 2060. The number of the oldest old (aged 80 and over) is projected to increase more rapidly, almost tripling from 22 million in 2008 to 61 million in 2060 [3]

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