ANCIENTypologies of LTC systemsbased on use and financing of care

Esther Mot (CPB)Peter Willemé (FPB)

asisp Annual Network Meeting, March 30, 2011

ANCIEN, general information

Assessing Needs of Care in European Nations

research for EC in 7th Framework Programme

January 2009 – August 2012

21 EU-countries included

ANCIEN, general information 2

Coordination: Center for European Policy Studies (CEPS): Güldem

Okem

Scientific coordination Federal Planning Bureau (FPB): Peter Willemé Netherlands Bureau for Economic Policy Analysis (CPB):

Esther Mot

Work package 1 managed by Institut für Höhere Studien, Wien

ANCIEN, objectives describe and characterise systems of LTC in

Europe

analyse the need for care (in relation to demography and lifestyle)

analyse developments in the supply and demand for formal and informal care

analyse the potential role of technology in solving LTC problems

ANCIEN, objectives continued analyse efforts to improve the quality of

LTC

project the use of LTC on the basis of developments in need and supply

evaluate the performance of different types of LTC systems

Work Package 1

description of LTC-systems in Europe

development of typology

selection of countries to model needs (demography, lifestyle) supply (formal and informal) use of care

WP1, data collection data on LTC collected by national experts

standardised format problems with data collection

country reports

typologies

WP1, two methods of clustering mostly organisational, 21 countries

Means-testing, entitlement Availabilility of cash benefits, choice of

provider Quality assurance, coordination Cost-sharing for types of LTC Public expenditure as share of GDP

use and financing of care, 14 countries

Use and financing typology selection of 8 metric variables for 14

countries

cluster-analysis factor analysis on 8 variables, 4 variables used k-means clustering meta-analysis

Variables public spending* (related to GDP and needs)

share of private expenditures* informal care use* IC support* formal care use role of cash benefits accessibility targeting

Result

Result, by clusterinformal care oriented, low private financing

Belgium*, Czech Republic, Germany, Slovakia* medium spender

low spending, low private, high IC use, high IC support,cash benefits modest

generous, accessible and formalized

Denmark, the Netherlands, Sweden

high spending, low private, low IC use, high IC support,cash benefits modest

informal care oriented, high private financing

Austria, England, Finland, France, Spain

medium spending, high private, high IC use, high IC support,cash benefits high

high private financing, informal care seems necessity

Hungary, Italy

low spending, high private, high IC use, low IC support,cash benefits medium

Star plot of LTC systems

Organisational typology

Comparison of typologies attractiveness ordering of systems

making assumptions on preferences

results similar ordering for 10 countries different for Belgium, France, Germany and

Italy extent of private funding can partly explain

differences

Countries to be modelled (considering data availability) Germany

the Netherlands

Spain

Poland (?)

Comparison of selected countries and Finland

Germany Netherlands Finland Spain Poland

cluster 1 2 3 3 4 (?)

public spending

% GDP 0.9 2.1 1.8 0.5 0.4

corrected pop. 65+

0.046 0.146 0.111 0.03 0.03

private funding

share of total

27% (all ages)

15% (all ages)

28% 28% 21 – 40%

Comparison, continuedGermany Netherlands Finland Spain Poland

informal care use

% pop. 65+ 17.5 6.7 15.1 17 NA

informal care support

benefits and income support

6 6 6 6 4

formal care use

% pop. 65+ 6.9 27.4 19.9 7.8 NA

cash benefits

euro, average HBC+FIC, corrected

129 420 87 672 96

accessi-bility

high high high low low

targeting high medium NA high high

Conclusion large impact of available information

different clustering with richer dataset

3 variables crucial: needs-corrected public spending, private

funding, informal care support

Conclusion 2 stable clustering of Nordic countries with

generous systems with large role for formal care (under different approaches): Sweden, Denmark, Netherlands

important role for informal care in all other clusters distinction by private financing, IC support, use

of formal care, role of cash benefits

Conclusion 3 most new member states only to be

analysed with organisational approach

low financial generosity for most NMS Latvia and Slovenia exceptions

large differences in organisational depth among NMS

More information:

http://www.ancien-longtermcare.eu/ general information country reports on LTC systems typology report:

Kraus, M., M. Riedel, E. Mot, P. Willemé, G. Röhrling, T. Czypionka (2010), A typology of systems of Long-Term Care in Europe - Results of Work Package 1 of the ANCIEN Project

mot@cpb.nl (Netherlands Bureau for Economic Policy Analysis)