long term community care in oecd countries - colombo
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LONG-TERM COMMUNITY CARE IN OECD COUNTRIESRecent trends in the provision and financing of long-term community care in OECD countries, and policy implications
Francesca Colombo, Head of Health DivisionDirectorate for Employment, Labour and Social Affairs
There is huge variation in what countries currently spend on LTC
Mixed systems
There are a range of different funding systems for meeting these costs
Comprehensive, universal, tax-funded systems
Means-tested safety net system
Universal LTC insurance - more comprehensive
- larger copayments
Nordic countries
Netherlands, Japan
Germany, Korea
England, United States
More comprehensiveWider accessMore expensive
Multiple universal systems
Italy, Czech Republic
Income-related universal benefits
France, Ireland, Austria
Mix of universal and means-tested benefits
Switzerland, Spain
Most OECD countries place a high priority on promoting community care
Source: Help Wanted? (OECD, 2011)
Efforts to promote community care have been successful
Proportion of LTC users living in the community
Source: OECD health statistics 2014
Although most spending is still on residential care
Expenditure on long-term care by setting (% of GDP)
Community care implies a large role for informal carers
Estimated value of formal and informal services for people with dementia in England
Source: Prince, Knapp et al. (2014)
Promoting community care must be coupled with policies to support carers
Help with employment
• Germany: “family caring time” law helps carers reduce hours temporarily
• Canada: bringing together employers to explore how to help carers to keep working
Information and training
• Provide skills to care effectively and minimise negative impacts
• e.g. France: carers entitled to two days of training per year.
• Phone advice services in a number of countries
Counselling and support
• Can be effective at relieving stress
• Include peer support, e.g.
• dementia cafés in Japan
• NHS Dementia Carers’ Support Service in England
Respite care
• At home, day care centres or temporary institutional care
• Available but underused?
• Netherlands: day care on farms provides respite to carers
There are also important considerations around gender equality
Source: Help Wanted? (OECD, 2011)
The likelihood of a person aged 50-64 being an informal carer, by gender
Thank you
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Websites: www.oecd.org/els ;
www.oecd.org/health/dementia.htm
www.oecd.org/health/long-term-care.htm