Planning the home and facility-based care dynamics using the multiple decrement approach: The case study for Slovenia

Abstract

Physical environment, especially urban facilities that are age-friendly are of particular importance for those growing older. Investments in facilities and changes in the environment can lower the disability threshold and travelling costs for caregivers and other suppliers. It influences the needs for care in each category of dependency, measured by care dependency scale. The good planning of a Home Health Care Structure requires a resolution of several complex challenges, dependent on dynamics of the rapid ageing of the European population. Therefore the spatial interaction model developed individually for each group of functional capacity can improve the forecast of overall dynamics of the structure according to age cohorts of older persons in care, and optimise investments in home care systems and other facilities in the framework of regional and urban spatial planning. The method for calculation of expected future structure of cohorts and human resources required for the care of older adults which are dependent on the help of others is given. As a novelty, the actuarial present value of lifetime care costs is a subject of criterion function at a given life expectancy. Here the disability thresholds are determined in a given environment, and the needed capacities are forecasted using the asymmetric Lowry-like gravity model associated with the multi-state transition approach. The numerical example shows how we can plan the dynamics of needed investments in facilities and human resources based on the forecasted structure of care dependency categories if some new financial mechanisms for seniors are available and the tax system is friendly to older cohorts.