long term community care in oecd countries - colombo

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

Contact: francesca.colombo@oecd.org

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Websites: www.oecd.org/els ;

www.oecd.org/health/dementia.htm

www.oecd.org/health/long-term-care.htm