long term community care in oecd countries - colombo
TRANSCRIPT
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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
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There is huge variation in what countries currently spend on LTC
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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
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Most OECD countries place a high priority on promoting community care
Source: Help Wanted? (OECD, 2011)
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Efforts to promote community care have been successful
Proportion of LTC users living in the community
Source: OECD health statistics 2014
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Although most spending is still on residential care
Expenditure on long-term care by setting (% of GDP)
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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)
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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
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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
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Thank you
Contact: [email protected]
Read more about our work Follow us on Twitter: @OECD_Social
Websites: www.oecd.org/els ;
www.oecd.org/health/dementia.htm
www.oecd.org/health/long-term-care.htm