Transcript ANCIEN - ancien-longtermcare.eu

ANCIEN
Typologies of LTC systems
based on use and financing of care
Esther Mot (CPB)
Peter Willemé (FPB)
asisp Annual Network Meeting, March 30, 2011
ANCIEN, general information
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Assessing Needs of Care in European
Nations
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research for EC in 7th Framework
Programme
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January 2009 – August 2012
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21 EU-countries included
ANCIEN, general information 2
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Coordination:
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Scientific coordination
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Center for European Policy Studies (CEPS): Güldem
Okem
Federal Planning Bureau (FPB): Peter Willemé
Netherlands Bureau for Economic Policy Analysis (CPB):
Esther Mot
Work package 1
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managed by Institut für Höhere Studien, Wien
ANCIEN, objectives
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describe and characterise systems of LTC in
Europe
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analyse the need for care (in relation to
demography and lifestyle)
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analyse developments in the supply and demand
for formal and informal care
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analyse the potential role of technology in solving
LTC problems
ANCIEN, objectives continued
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analyse efforts to improve the quality of
LTC
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project the use of LTC on the basis of
developments in need and supply
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evaluate the performance of different
types of LTC systems
Work Package 1
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description of LTC-systems in Europe
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development of typology
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selection of countries to model
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needs (demography, lifestyle)
supply (formal and informal)
use of care
WP1, data collection
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data on LTC collected by national experts
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standardised format
problems with data collection
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country reports
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typologies
WP1, two methods of clustering
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mostly organisational, 21 countries
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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
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selection of 8 metric variables for 14
countries
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cluster-analysis
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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
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Result
Result, by cluster
informal care
oriented, low
private financing
Belgium*,
Czech Republic,
Germany,
Slovakia
low spending, low private,
high IC use, high IC support,
cash benefits modest
* medium spender
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
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attractiveness ordering of systems
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making assumptions on preferences
results
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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)
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Germany
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the Netherlands
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Spain
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Poland (?)
Comparison of selected countries and Finland
Germany
Netherlands
Finland
Spain
Poland
1
2
3
3
4 (?)
% GDP
0.9
2.1
1.8
0.5
0.4
corrected
pop. 65+
0.046
0.146
0.111
0.03
0.03
share of
total
27% (all
ages)
15% (all
ages)
28%
28%
21 –
40%
cluster
public
spending
private
funding
Comparison, continued
Germany
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
accessibility
high
high
high
low
low
targeting
high
medium
NA
high
high
Conclusion
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large impact of available information
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different clustering with richer dataset
3 variables crucial:
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needs-corrected public spending, private
funding, informal care support
Conclusion 2
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stable clustering of Nordic countries with
generous systems with large role for
formal care (under different approaches):
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Sweden, Denmark, Netherlands
important role for informal care in all
other clusters
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distinction by private financing, IC support,
use of formal care, role of cash benefits
Conclusion 3
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most new member states only to be
analysed with organisational approach
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low financial generosity for most NMS
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Latvia and Slovenia exceptions
large differences in organisational depth
among NMS
More information:
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http://www.ancien-longtermcare.eu/
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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
[email protected] (Netherlands Bureau for Economic
Policy Analysis)