Introduction. Challenges in Long-Term Care in Europe

• Autorzy: Milena Pavlova , Lena Praznovszky , Marzena Tambor , Stanisława Golinowska , Wim Groot
• Języki publikacji: EN

Abstrakty

EN

European societies are ageing and the share of older persons is continuously increasing across the region. In 1950, only 12% of the European population was over 65 years old. At present, this share is already doubled and the estimations suggest that it will be over 36% in 2050. The ageing phenomenon is caused by the decreased fertility and increased life expectancy. While in the past, a woman in Europe had on average more than 2 children, since 2000, the fertility rate has fallen below that threshold. Next to that, European citizens live longer, 75 years on average at present compared to 66 years on average in the 1950's. Prolonged human life is a symbol of wealth and prosperity within the European societies but combined with the low fertility rate, it also creates challenges. Most importantly, the group of working people who can provide care to the older persons is shrinking while the group of older persons is becoming larger. Moreover, the increase of longevity is accompanied with a decreasing proportion of years spent independently. Women are particularly affected since most of their years in old age are spent in dependency. The imbalance between the demand and supply is expected to lead to shortages in care providers, a trend already experienced by countries with fast ageing population. The increased demand for care will require not only more care providers but also more financial resources. In 2014, the public spending on long-term care in the OECD countries was 1.4% of GDP but projections suggest that this share will substantially increase till 2050. There are however substantial differences across the European countries. The highest public spending on long-term care is observed in the Netherlands and Scandinavian countries (3-4% of GDP) and lowest in countries of Central and Eastern Europe, e.g. less than half percent in Poland, Hungary, Estonia and Latvia. This difference is not surprising given the difference in the long-term care systems in Europe and their historical development. While the Netherlands and Scandinavian countries have well developed systems of care for older persons, which offer a broad range of services, in Central and Eastern European countries, these systems are underdeveloped. The expansion and improvement of medical care provision in these countries during the communist period was not coupled with the same developments in long-term care (LTC). The care for elderly is still largely seen as the responsibility of the family. (fragment of text)

Słowa kluczowe

EN

Ageing of the population; Process of people ageing; Long-term care; Care for the elderly

PL

Starzenie się społeczeństw; Proces starzenia się ludności; Opieka długoterminowa; Opieka nad osobami starszymi

• Czasopismo: Zdrowie Publiczne i Zarządzanie
• Rocznik: 2019
• Tom: 17
• Numer: nr 3
• Strony: 113--118

Twórcy

autor

Milena Pavlova

• Maastricht University, the Netherlands

autor

Lena Praznovszky

• Maastricht University, the Netherlands

autor

Marzena Tambor

• Jagiellonian University, Cracow, Poland

autor

Stanisława Golinowska

• Jagiellonian University, Cracow, Poland

autor

Wim Groot

• Maastricht University, the Netherlands

Bibliografia

• United Nations, Department of Economic and Social Affairs, Population Division, World Population Ageing 2015 (ST/ESA/SER.A/390), https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Report.pdf (accessed: 10.11.2019).
• Kingston A., Wohland P., Wittenberg R., Robinson L., Brayne C., Matthews F.E.,..., Arthur A., Is late-life dependency increasing or not? A comparison of the Cognitive Function and Ageing Studies (CFAS), "The Lancet" 2017; 390 (10103): 1676-1684.
• OECD, Long-term Care, 2019, http://www.oecd.org/els/health-systems/long-term-care.htm (accessed: 11.12.2019).
• European Commission, Joint Report on Health Care and Long-Term Care Systems & Fiscal Sustainability, Vol. 1, European Commission, Brussels 2016.
• Leichsenring K., Billings J., Nies H., Long-term Care in Europe: Improving Policy and Practice, Palgrave Macmillan, Basingstoke, UK 2013.
• WHO, Everybody's business-strengthening health systems to improve health outcomes: WHO's framework for action, 2007, https://apps.who.int/iris/bitstream/handle/10665/43918/9789241596077_eng.pdf (accessed: 10.09.2019).
• Held D., Models of Democracy, Stanford University Press, Redwood City, CA 2006.
• Olsen J.P., Democratic order, autonomy and accountability, in: The Routledge Handbook to Accountability and Welfare State Reforms in Europe, Routledge, Abingdon, UK 2016: 29-44.
• Pfau-Effinger B., Culture and welfare state policies: Reflections on a complex interrelation, "Journal of Social Policy" 2005; 34 (1): 3-20.
• Theobald H., Restructuring elder care systems in Europe: Policy-field, policy transfer and negative integration. Paper presented at the ISA Conference, "Social Policies: Local Experiments, Travelling Ideas", Montreal 2009, https://www.researchgate.net/profile/Hildegard_Theobald/publication/242481850_Restructuring_elder_care_systems_in_Europe_Policy-field_policy_transfer_and_negative_integration/links/0c96052e0dd6899aee000000.pdf (accessed: 03.11.2019).
• 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.
• Theobald H., Kern K., The introduction of long-term care policy schemes: Policy development, policy transfer and policy change, "Policy & Politics" 2011; 39 (3): 325-342.
• Zaidi A., Gasior K., Zolyomi E., Schmidt A., Rodrigues R., Marin B., Measuring active and healthy ageing in Europe, "Journal of European Social Policy" 2017; 27 (2): 138-157.
• Boudiny K., Mortelmans D., A critical perspective: Towards a broader understanding of' active ageing', "E-journal of Applied Psychology" 2011; 7 (1): 8-14.
• Lassen A.J., Moreira T., Unmaking old age: Political and cognitive formats of active ageing, "Journal of Aging Studies" 2014; 30: 33-46.
• Vabo S.I., Actors and governance arrangements in long-term care for older people, in: Rescaling Social Policies towards Multilevel Governance in Europe, Routledge, Abingdon, UK 2017: 343-363.
• 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.
• Riedel M., Kraus M., Mayer S., Organization and supply of long-term care services for the elderly: A bird's-eye view of old and new EU member states, "Social Policy & Administration" 2016; 50 (7): 824-845.
• Barlow J., Roehrich J., Wright S., Europe sees mixed results from public-private partnerships for building and managing health care facilities and services, "Health Affairs" 2013; 32 (1): 146-154.
• Costa-Font J., Courbage C., Long-Term Care Insurance: Partnership or Crowding Out?, in: Financing Long-Term Care in Europe, Palgrave Macmillan, London 2012: 91-100.
• Deusdad B.A., Pace C., Anttonen A., Facing the challenges in the development of long-term care for older people in Europe in the context of an economic crisis, "Journal of Social Service Research" 2016; 42 (2): 144-150.
• Harrington C., Jacobsen F.F., Panos J., Pollock A., Sutaria S., Szebehely M., Marketization in long-term care: A crosscountry comparison of large for-profit nursing home chains, "Health Services Insights" 2017; 10: 1178632917710533.
• Pavolini E., Ranci C., Restructuring the welfare state: Reforms in long-term care in Western European countries, "Journal of European Social Policy" 2008; 18 (3): 246-259.
• Costa-Font J., Courbage C., Swartz K., Financing long-term care: Ex ante, ex post or both?, "Health Economics" 2015; 24: 45-57.
• Rothgang H., Social insurance for long-term care: An evaluation of the German model, "Social Policy & Administration" 2010; 44 (4): 436-460.
• Hassink W.H., Van den Berg B., Time-bound opportunity costs of informal care: consequences for access to professional care, caregiver support, and labour supply estimates, "Social Science & Medicine" 2011; 73 (10): 1508-1516.
• Oliva-Moreno J., Peña-Longobardo L.M., Vilaplana-Prieto C., An estimation of the value of informal care provided to dependent people in Spain, "Applied Health Economics and Health Policy" 2015; 13 (2): 223-231.
• Karimi M., Brazier J., Health, health-related quality of life, and quality of life: What is the difference?, "Pharmacoeconomics" 2016; 34 (7): 645-649.
• Şahin D.S., Özer Ö., Yanardağ M.Z., Perceived social support, quality of life and satisfaction with life in elderly people, "Educational Gerontology" 2019; 45 (1): 69-77.
• Coleman E.A., Falling through the cracks: challenges and opportunities for improving transitional care for persons with continuous complex care needs, "Journal of the American Geriatrics Society" 2003; 51 (4): 549-555.
• Berg K., Mor V., Morris J., Murphy K.M., Moore T., Harris Y., Identification and evaluation of existing nursing homes quality indicators, "Health care Financing Review" 2002; 23 (4): 19.
• Greve B., Long-term Care for the Elderly in Europe: Development and Prospects, Routledge, Abingdon, UK 2016.
• Kim E.-Y., Yang B.-M., Cost-effectiveness of long-term care services in South Korea, "Archives of Gerontology and Geriatrics" 2005; 40 (1): 73-83.
• Lau J.Y.C., Wong E.L.Y., Chung R.Y., Law S.C., Threapleton D., Kiang N.,..., Yeoh E.K., Collaborate across silos: Perceived barriers to integration of care for the elderly from the perspectives of service providers, "The International Journal of Health Planning and Management" 2018; 33 (3): e768-e780.
• Busse R., Competition in healthcare - a health systems' perspective, "Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen" 2009; 103 (10): 608-615.
• Leichsenring K., Integrated care for older people in Europe - latest trends and perceptions, "International Journal of Integrated Care" 2012; 12.
• Arentshorst M.E., Kloet R.R., Peine A., Intergenerational Housing: The Case of Humanitas Netherlands, "Journal of Housing For the Elderly" 2019; 33 (3): 244-256.
• Tinker A., Ginn J., Ribe E., Assisted living platform - The long term care revolution: A study of innovatory models to support older people with disabilities in the Netherlands, King's College London, London 2013.
• Fujisawa R., Colombo F., The long-term care workforce: overview and strategies to adapt supply to a growing demand, 2009, https://www.oecd-ilibrary.org/social-issues-migration-health/the-long-term-care-workforce-overview-and-strategies-to-adapt-supply-to-a-growing-demand_225350638472?crawler=true (accessed: 10.12.2019).
• Kuhlmann E., Batenburg R., Groenewegen P.P., Larsen C., Bringing a European perspective to the health human resources debate: A scoping study, "Health Policy" 2013; 110 (1): 6-13.
• Aiken L.H., Sloane D.M., Bruyneel L., Van den Heede K., Sermeus W., Consortium R., Nurses' reports of working conditions and hospital quality of care in 12 countries in Europe, "International Journal of Nursing Studies" 2013; 50 (2): 143-153.
• Hollinger-Smith L., Ortigara A., Changing culture: Creating a long-term impact for a quality long-term care workforce, "Alzheimer's Care Today" 2004; 5 (1): 60-70.
• Hussein S., Manthorpe J., An international review of the long-term care workforce: Policies and shortages, "Journal of Aging & Social Policy" 2005; 17 (4): 75-94.
• Chen L., Evans T., Anand S., Boufford J.I., Brown H., Chowdhury M.,..., Elzinga G., Human resources for health: overcoming the crisis, "The Lancet" 2004; 364 (9449): 1984-1990.
• Rahmani A.M., Gia T.N., Negash B., Anzanpour A., Azimi I., Jiang M., Liljeberg P., Exploiting smart e-Health gateways at the edge of healthcare Internet-of-Things: A fog computing approach, "Future Generation Computer Systems" 2018; 78: 641-658.
• Georgiou A., Marks A., Braithwaite J., Westbrook J.I., Gaps, disconnections, and discontinuities - the role of information exchange in the delivery of quality long-term care, "The Gerontologist" 2012; 53 (5): 770-779.
• Kruse C.S., Mileski M., Alaytsev V., Carol E., Williams A., Adoption factors associated with electronic health record among long-term care facilities: a systematic review, "BMJ Open" 2015; 5(1): e006615.
• Marcotte L., Kirtane J., Lynn J., McKethan A., Integrating health information technology to achieve seamless care transitions, "Journal of Patient Safety" 2015; 11 (4): 185-190.
• van der Haak M., Wolff A.C., Brandner R., Drings P., Wannenmacher M., Wetter T., Data security and protection in cross-institutional electronic patient records, "International Journal of Medical Informatics" 2003; 70 (2-3): 117-130.
• Liu D., Castle N.G., Health information technology in nursing homes, "Journal of Applied Gerontology" 2009; 28 (1): 38-58.
• Agree E.M., The potential for technology to enhance independence for those aging with a disability, "Disability and Health Journal" 2014; 7 (1): S33-S39.
• Barlow J., Singh D., Bayer S., Curry R., A systematic review of the benefits of home telecare for frail elderly people and those with long-term conditions, "Journal of Telemedicine and Telecare" 2007; 13 (4): 172-179.
• Pavlova M., Innovative Mechanisms for Sustainable Long-Term Care Systems in Europe - EuroLTCS Project, 2016, https://www.axa-research.org/en/project/milena-pavlova (accessed: 10.11.2019).

Identyfikatory

DOI

10.4467/20842627OZ.19.013.11970