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Long-term Care for Older People : Oecd Health Project Ser. - OECD

Long-term Care for Older People

Oecd Health Project Ser.

By: OECD (Created by)

Paperback

Published: 14th October 2005
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When the baby-boom generation reaches the oldest age groups over the next three decades, demand for long-term care will rise steeply. How do governments in OECD countries respond to this growing demand? What has been done to increase access to long-term care and to improve the quality and affordability of services? Are there examples of successful strategies to improve the mix of services and policies to enable a larger number of older persons to stay in their homes? And has this helped contain the costs of caring for the elderly?This study reports on the latest trends in long-term care policies in nineteen OECD countries: Australia, Austria, Canada, Germany, Hungary, Ireland, Japan, Korea, Luxembourg, Mexico, the Netherlands, New Zealand, Norway, Poland, Spain, Sweden, Switzerland, the United Kingdom, and the United States. It studies lessons learned from countries that undertook major reforms over the past decade. Trends in expenditure, financing, and the number of care recipients are analyzed based on new data on cross-country differences. Special attention is given to experience with programs that provide consumers of services with a choice of care options, including cash to family caregivers. Concise country profiles of long-term care systems and an overview on demography and living situations of older persons make this complex policy field more accessible.

Executive Summaryp. 9
Introductionp. 15
An Overview of Long-term Care Programmes and Expendituresp. 19
Introductionp. 20
The nature of long-term care servicesp. 20
A wide range of long-term care coverage by public programmesp. 21
Differences in spending levels for long-term care servicesp. 25
Notesp. 32
Towards a Continuum of Care: Bringing Services Togetherp. 33
Introductionp. 34
The continuum of carep. 34
National measures to improve the continuum of carep. 35
Shifting the balance towards home-based carep. 40
Services to support carersp. 44
Conclusionsp. 46
Notesp. 47
Consumer Direction and Choice in Long-term Carep. 49
Introductionp. 50
Arrangements to increase consumer-direction and choice when receiving long-term care at homep. 51
Aspects of programme designp. 57
Outcomes: what is the experience with choice of carer and payments for care?p. 59
Conclusionsp. 62
Notesp. 63
Monitoring and Improving the Quality of Long-term Carep. 65
Introductionp. 66
What do we know about quality deficits in long-term care?p. 66
Efforts to monitor and improve quality in long-term carep. 71
The cost of improving housing standards and quality of accommodationp. 76
Conclusionsp. 77
Paying for Long-term Care: Current Reforms and Issues for the Futurep. 79
Introductionp. 80
New forms of public programmes for long-term care: Austria, Germany, Japan and Luxembourgp. 81
Reforms to long-term care within the tax envelope: Sweden, Australia, New Zealand and the United Kingdomp. 85
Conclusionsp. 88
Notesp. 89
Referencesp. 91
Demographic Trends and Changes in Living Arrangements of Older Personsp. 99
Introductionp. 99
Demographic trendsp. 99
Disability in older agep. 102
The role of informal care giving and trends in labour market participationp. 108
Living arrangements of older personsp. 108
Profiles of Long-term Care Systems in 19 Countriesp. 113
Australiap. 113
Austriap. 115
Canadap. 116
Germanyp. 117
Hungaryp. 119
Irelandp. 120
Japanp. 122
Koreap. 123
Luxembourgp. 124
Mexicop. 125
Netherlandsp. 126
New Zealandp. 127
Norwayp. 128
Polandp. 129
Spainp. 130
Swedenp. 132
Switzerlandp. 133
United Kingdomp. 134
United Statesp. 136
Notesp. 137
List of boxes
Definitions and glossary of termsp. 17
Long-term care systems serve all age groupsp. 25
What can we learn from future projections of spending on long-term care?p. 31
Consumer-directed care programmes in the United Statesp. 51
The role of the Internet in strengthening the role of the public and of consumers of servicesp. 75
List of tables
Major public programmes covering long-term care in selected OECD countries, 2003p. 22
Public and private expenditure on long-term care as a percentage of GDP, 2000p. 26
Interventions on a continuum-of-care for stroke and dementia patientsp. 35
Measures introduced in OECD countries to improve the continuum of carep. 37
Recipients of institutional and home-care services aged 65 and overp. 41
Decreasing rates of nursing home use in the United States, 1985 to 1999p. 42
Recent initiatives to support more disabled older people at homep. 44
Personal budgets, consumer-directed care and payments for informal carep. 52
Dimensions and aspects of quality in long-term carep. 67
Evidence on quality deficits in nursing home carep. 68
Policy concerns about the quality of nursing home carep. 69
Policy concerns about the quality of home-care servicesp. 70
Privacy in nursing homesp. 77
Public long-term care benefits in five countriesp. 82
Share of older persons in the population, 1960 to 2040p. 101
Share of very old persons (80+) among the elderly, 1960 to 2040p. 102
Life expectancy at age 65 and 80, 1960 to 2000p. 103
Old age-dependency ratio, 1960 to 2040p. 104
Disability-free life expectancy at age 65, selected countriesp. 107
Relationship between care recipient and informal care giverp. 109
Age distribution of care giversp. 110
List of figures
Public and private expenditure on long-term care as a percentage of GDP, 2000p. 26
The correlation between total long-term care spending and the population share of the very elderly, 2000p. 27
Public expenditure on long-term care as a percentage of GDP, 2000p. 28
Share of spending on institutional care in total public long-term care expenditure, 2000p. 29
The role of private spending on care in institutionsp. 30
Trends in public spending on long-term care, 1990-2002p. 32
Prevalence of disability by age and genderp. 105
Female labour force participation by age groups, 1980 and 2002p. 111
Trends of older persons living alone, 1990 to 2000p. 112
Table of Contents provided by Ingram. All Rights Reserved.

ISBN: 9789264008489
ISBN-10: 9264008489
Series: Oecd Health Project Ser.
Audience: Professional
Format: Paperback
Language: English
Number Of Pages: 138
Published: 14th October 2005
Publisher: Organization for Economic Co-operation and Development (OECD)
Country of Publication: FR
Dimensions (cm): 25.4 x 19.0  x 0.7
Weight (kg): 0.02