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Long-Term Care

The demographic situation in Europe is such that in the next decade there will be increasing needs for long term care. Long term care is different from medical cure and implies the involvment of paramedical personnel and helpers. The human and capital investments required to cover these increasing needs are huge and European countries are currently exploring news ways of financing them. Moreover, improving collaboration between teams responsible for cure and caretakers is an important issue to address individuals' specific needs. Long term care is often provided in residential and nursing facilities but healthcare systems are encouraging people to receive care at home for as long as possible. Expenditure on long term care is expected to rise in countries of the European Union from 1.3 % of GDP to 2.9% in 2050.

Source : « Help Wanted? Providing and Paying for Long-Term Care », OECD, June 2011

 

Health Status

Aggregate data

  • Austria: The Ministry of Labour, Social Affairs and Consumer Protection issues a yearly publication on the state of long-term care in Austria, containing information on how many benefit from (Federal and Laender) allowances by sex, age, region and degree of dependency [in German only]
  • Finland: Statistics Finland collects and files causes of death (according to ICD-10-Codes) for all citizens in Finland. pfeil zu
  • Finland: SOTKAnet (THL) provides data on demographic variables and healthcare provision at regional level as well as epidemiological key themes (e.g. life expectancy, mortality, cancer incidence, self-reported health)
  • Finland: KELASTO database maintained by the Social insurance institution provides annual data on drug reimbursements, sickness leave, rehabilitation and other allowances. pfeil zu
  • France: Health surveys - elderly persons are published by the research and statistics branch of the Ministry of Health (DREES) including the 2011 survey on housing facilities and residential care facilities for the elderly (EHPA, EHPAD), latest of a series which surveyed all such facilities in quadrennial (from 1996) and biennial rounds (1984-1994). Aggregates derived from reported health status of respondents with comprehensive morbidity of sample group of patients from sample of facilities.
  • France: Health-handicap surveys, the Institutions component  of the survey includes health status information. Surveys were carried out in two rounds (1999 and 2009 for the component). Published by the research and statistics branch of the Ministry of Health (DREES), the 2009 institutions component covers 9000 people from 1500 facilities. Aggregates derived from reported health status of respondents, including self-reported health (Mini European module) and clinically reported morbidity (ICD-10).
  • Germany: Feredal Bureau of Statistics publishes a detailed yearly report on the current situation in long-term care,nursing services,  number of people in need of care, ect. called  'Pflegestatistik' [published in German only]
  • Israel: Elderly in Israel Statistical abstract 2011 – Aggregated data on the elderly population in Israel, include data on life expectancy, death, suicides, health status etc.
  • Israel: Elderly health in the community survey [Hebrew]- Aggregated data on diagnoses, health status and demographic data.
  • Israel: Central bureau of statistics, mortality and cause of death data – Aggregated data on adjusted and crude mortality rates by causes of death such as Diabetes, Tuberculosis, Cancer, etc. Causes of death derived from death certificates completed by the physician reporting the death and are coded according to ICD-10. Data is not separated by care provision.
  • Israel: Central bureau of statistics, 2009 Health survey data – Aggregated data on illnesses such as Hypertension, Diabetes etc. Data is not separated by care provision.

Individual level data

Quality (valued outcomes)

Aggregate data

  • France: Health surveys - elderly persons are published by the research and statistics branch of the Ministry of Health (DREES) including the 2011 survey on housing facilities and residential care facilities for the elderly (EHPA, EHPAD), latest of a series which surveyed all such facilities in quadrennial (from 1996) and biennial rounds (1984-1994). Aggregate quality indicators are derived from questions on perceived quality of care.
  • France: Health-handicap surveys, the Institutions component of the survey includes quality indicators. Surveys were carried out in two rounds (1999 and 2009 for the component). Published by the research and statistics branch of the Ministry of Health (DREES), the 2009 institutions component covers 9000 people from 1500 facilities. Aggregate quality indicators are derived from questions on institutions' practices (e.g. preventive care) and perceived quality of care by respondents.

Individual level data

Efficiency / Economy

Physical Inputs (infrastructure)

Aggregate data

  • Austria: Pflegedienstleistungsstatistik maintained by Statistics Austria provides data on employment in the long-term care sector by care type (inpatient care, short-term care etc.) and by region
  • Austria: ÖGIS provides detailed information on almost all subsectors of the health care system (e.g. acute care hospitals, rehabilitation centres, care homes and nursing homes, practice-based physicians, mobile care services or ambulance service centres). pfeil zu
  • France: Eco Santé IRDES data on healthcare supply, available at the national and regional levels; private and public hospitals, long term and nursing care.
  • France: STATISS presents regional and local level data on long term care capacity, with preset tables enabling easy benchmarking between regions. Hosted by the Ministry of Health.
  • France: Health-handicap surveys, the Informal Help component entails a noteworthy original survey of private inputs in long term care in the home setting, excluding institutional care. Respondents are persons providing assistance, social care services and/or help in a non-professional, voluntary capacity to a principal requiring long term care. The component was carried out in 2008 round of the Health-Handicap survey. Published by the research and statistics branch of the Ministry of Health (DREES), the component covers 5000 non-professional helpers. Aggregate indicators are derived from questions on respondents' self-reported measures of physical inputs for the care of the principal e.g. hours, frequency, nature of services, relief for care, housing, etc. -financial or in kind.
  • Germany: Pflege-Thermometer is a yearly nationwide survey of nursing personnel on the current situation of labour market for nursing professions in the country, concentrating specificly on current staffing situation and nursing personnel structure in intesince-care units of german hospitals. The survey is conducted by The German Institute of Applied Nursing Research (dip), reports in German only.
  • Israel: Statistical abstract of Israel by the central bureau of statistics - contain data on health services, among them long term services. Aggregated data on beds in hospitals and bed occupancy, discharges, hospitalization days and average length of stay in hospitals.
  • Israel: National Insurance Institute Annual Survey 2011- Aggregated data on claims for a long-term care benefit, Organizations providing long-term care services and the services provided, and expenditure on Long-Term Care Insurance Program
  • United Kingdom: The Office for National Statistics (ONS) has general data on long-term health care facilities as well as personnel and finance.

Individual level data

  • United Kingdom: HES database contains details of all admissions to long-term health care facilities in England. It contains aggregate and individual information on  clinical information about diagnoses and operations with information about the patient such as time waited and date of admission, geographical information on where the patient was treated and the area in which they lived. pfeil zu

Activity/Utilization

Aggregate data

  • Austria: Pflegedienstleistungsstatistik maintained by Statistics Austria contains data on beneficiaries of long-term care services by care type (inpatient care, short-term care etc.) and by region as well as beneficiaries of long-term care allowances provided by both the Federal government and the Laender.
  • France: Eco Santé IRDES at the national and regional levels, detailed information including  relevant data for long term care. Database covers hospital and outpatient activity (procedures, doctor visits, number of hospital admissions, average lengths of stay…).
  • Israel: National Insurance Institute Annual Survey 2011- Aggregated data on claims for a long-term care benefit, Organizations providing long-term care services and the services provided, and expenditure on Long-Term Care Insurance Program
  • Israel: Statistical abstract of Israel by the central bureau of statistics - contain data on health services, among them long term services. Aggregated data on beds in hospitals and bed occupancy, discharges, hospitalization days and average length of stay in hospitals.
  • Israel: Elderly health in the community survey [Hebrew]- Aggregated data on diagnoses, health status and demographic data, as well as utilization data.
  • Israel: Elderly in Israel Statistical abstract 2011 – Aggregated data on the elderly population in Israel, include data on physician visits, visits to emergency departments, vaccination etc.
  • United Kingdom: The NHS Information Centre has data available on long-term care utilization.

Individual level data

  • United KingdomHES database contains details of all admissions to long-term health care facilities in England. It contains aggregate and individual information on  clinical information about diagnoses and operations with information about the patient such as time waited and date of admission, geographical information on where the patient was treated and the area in which they lived. pfeil zu

Cost and Expenditure

Aggregate data

  • Austria: Statistics Austria provides a table compatible with SHA tables showing main aggregates of private and public health expenditure and investment since 1990 by type of provider (inpatient, outpatient, long-term care)
  • Austria: The Ministry of Labour, Social Affairs and Consumer Protection issues a yearly publication on the state of long-term care in Austria, containing information on the cost of long-term care allowances for the federal and Laender level by the beneficiaries' sex, age, region and degree of dependency [in German only]
  • Austria: Pflegedienstleistungsstatistik maintained by Statistics Austria provides data on full cost of long-term care services by care type (inpatient care, short-term care etc.) and by region as well as expenditure by both the Federal government and the Laender on long-term care allowances.
  • Finland: THL provides a table compatible with SHA tables showing main aggregates of private and public health expenditure and investment and publishes periodically the list of national reference (unit) prices of all important health and social services.
  • Finland: KELASTO database reports the payments for reimbursed drugs, rehabilitation, private health care services,sickness absence day and other special benefits reimbursed by the social security. pfeil zu
  • Finland: SOTKAnet provides data on costs by region. Data covers total costs and costs for primary care, hospital care and social (long-term) care per capita. pfeil zu
  • Germany: Federal Health Reporting System delivers data on expenditures, costs and financing of nursing care. More data available in German.
  • Israel: National Insurance Institute Annual Survey 2011- Aggregated data on claims for a long-term care benefit, Organizations providing long-term care services and the services provided, and expenditure on Long-Term Care Insurance Program
  • Israel: Elderly in Israel Statistical abstract 2011 – Aggregated data on the elderly population in Israel, include data on incomes and expenditures, among that health expenditure.
  • United Kingdom: The PSSRU holds data on unit costs of health and social care. Based on administrative data and considers all NHS costs.
  • United Kingdom: PESA collects outturn data, estimated outturn for the latest year and budgetary plans over the whole range of UK public expenditure.

Individual level data

Access/Equity

Aggregated data

Individual level data

  • United Kingdom: The British Household Panel Survey (BHPS) has comprehensive information on the socio-economic background and income of the individuals. Information about their households is also available. pfeil zu 

Health System Design and Context

Austria | Estonia | Finland | France | Germany | Israel | Luxembourg | United Kingdom

International Projects & Data

 Data

EuroBarometer pfeil zu | OECD pfeil zu | SHARE pfeil zu