WORKSHOP AGIR

THE HAGUE

FEBRUARY 14-15 2003

RESULTS FOR BELGIUM – WP2

J. MESTDAGH – M. LAMBRECHT

Aaaaa&&

Federal Planning Bureau

Economic Analysis &

Forecasts

WP2 - Results Belgium

TABLE OF CONTENTS

• Demand for (use of ) health care

• Long term care at home / in institutions

• Supply of health care

• Household composition / family situation

• Labour market developments

Hospital admissions

Average number of admissions, 1998, by age and gender

Highest at age 0, then decrease, to increase again with age Women are less frequently admitted except at age 15-34

0.000.200.400.600.801.001.201.40

0-1 1-4 5-9 10-14

15-24

25-34

35-44

45-54

55-64

65-74

74+

men

w omen

Hospital admissions (2)Average number of admissions – 1991 – 1998, by gender / age

Increase between 1991-’98 for younger and older age groupsDecrease between 1991-’98 between age 1 and 45

0.0

0.2

0.4

0.6

0.8

1.0

1.2

0-1 1-4 5-9 10-14 15-24 25-34 35-44 45-54 55-64 65-74 74+

men 1991

men 1998

women 1991

women 1998

Length of hospital stay Average length of hospital stay by age group and gender, 1998

Positive relation with age : increases as people get olderHigher for women than for men, especially in oldest age group

02468

10121416

0 1-4 5-9 10-14

15-24

25-34

35-44

45-54

55-64

65-74

75+

men

w omen

Length of hospital stay (2)

Average length of hospital stay by age group / gender, 1991-98

Decrease between 1991-1998, men/women, all age groups

0.0

5.0

10.0

15.0

20.0

25.0

0-1 1-4 5-9 10-14

15-24

25-34

35-44

45-54

55-64

65-74

74+

men 91

men 98

women 91

women 98

Volume of hospital stay

Volume of hospital stay, 1998, by gender and age

0

1

2

3

4

5

6

7

0 1-4 5-9 10-14

15-24

25-34

35-44

45-54

55-64

65-74

75+

men

w omen

Volume of hospital stay (2)

Volume of hospital stay, by age and gender, 1991 – 1998

Slight decrease between 1991 and 1998, all ages

0

1

2

3

4

5

6

7

8

0 1-4 5-9 10-14

15-24

25-34

35-44

45-54

55-64

65-74

75+

men 91

men 98

women 91

women 98

Contacts with doctorAverage number of contacts a year, by age group and gender,

2001 (National Health Survey)

Number of contacts increases with age Higher for women than for men (except youngest age group)

0

2

4

6

8

10

12

14

0-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75+

Men

Women

Contacts with doctor (2)Contacts with doctor by gender and age, 1997- 2001 (NHS)

Again positive relation with ageFor men and women, more contacts in 2001 than in 1997,

EXCEPT: women in oldest age group (!!)

0

2

4

6

8

10

12

14

16

18

0-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75+

men 97

men 01

women 97

women 01

Long term care at home % of population using LTC at home by age group, 1998 – 2001

Clear positive relation with age : increases as people get olderLittle evolution in time, only small increase for oldest group

0

5

10

15

20

25

30

0-59 60-74 75-79 80-84 85-89 90-94 95+

1998

2001

Long term care at home (2)% of population using LTC at home, 2001, by category

Positive relation with age, % increases as people get older% lower for higher degrees of dependence (cfr. Institutions)

0

2

4

6

8

10

12

60-74 75-79 80-84 85-89 90-94 95+

Bathroom

A

B

C

Long term care at home (3)

% of population using home-delivered meals, age / gender, 2001

Positive relation with age; % increases as people get olderNo clear difference between men and womenNote: similar data for 1997 (no increase or decrease in use)

0

5

10

15

20

25

60-64 65-69 70-74 75-79 80-84 85+

men

w omen

Long term care at home (4)

% of population receiving help in household, 2001, age/gender

Positive relation with age; % increases as people get olderHigher for women than for men, in all age groups

0

5

10

15

20

25

30

35

0-14 15-24 25-34 35-44 45-54 55-64 65-74 75+

men

w omen

LTC in institutions (2)

% of population living in ROB-RVT by age group, 1996-2001

Positive relation with age; % increases as people get older Increase between 1996-2001, especially at older ages

0

10

20

30

40

50

60

70

80

0-59 60-74 75-79 80-84 85-89 90-94 95+

1996

2001

LTC in institutions (3)

% of population in ROB-RVT, by age group and category, 2001

Positive relation with age; % increases as people get older In older age groups, categories with higher dependence become

more important

05

1015202530354045

75-79 80-84 85-89 90-94 95+

O

A

B

C

Forecasting exercise

• Use of long term care at home 2030-2050

Increase of 124%: 277.432 people in 2050 compared to 123.566 in 2001

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

<60 60-74 75-79 80-84 85-89 90-94 95+

2001

2030

2050

Forecasting exercise (2)

• Use of LTC in institutions, 2030-2050

Increase of 166%: 317.979 people in 2050 compared to 119.254 in 2001

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

<60 60-74 75-79 80-84 85-89 90-94 95+

2001

2030

2050

Supply of formal health care

Density of care givers (per 1000 inhabitants)

Slight increase in density for all, especially nurses

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

5.5

1995 1996 1997 1998 1999 2000

General practitioner

Specialists

Pharmacist

Nurses

Physical therapistis

Supply of formal health care (2)Density of care givers in ROB-RVT (per 1000 people

living in institutions)

0

20

40

60

80

100

120

140

160

180

1996 1997 1998 1999

carers

nurses

physical therapist

paramedical staff

Supply of formal health care (4)

Number of hospital beds for LTC per 1000 inhabitants aged 65+

Decrease in density of hospital beds for LTC

7.2

7.4

7.6

7.8

8

8.2

8.4

1990 1991 1992 1993 1994

Supply of formal health care (5)

Density of acknowledged beds in ROB-RVT per 1000 inhabitants older than 65

Overall slight increase in densityDecrease for ROB, increase for RVT

0

10

20

30

40

50

60

70

80

1996 1997 1998 1999 2000

ROB

RVT

ROB + RVT

Average household size

Average household size 1900 – 1999

Decrease from 4.3 in 1900 to 2.4 in 1999

2.0

2.5

3.0

3.5

4.0

4.5

1900 1910 1920 1930 1947 1961 1970 1981 1991 1999

Number of HH members

Evolution in share of households 1930-2001

Increase in proportion HH with 1 / 2 membersProportion of bigger families decreases

0

5

10

15

20

25

30

35

1 2 3 4 >=5

1930

1970

2001

32 31

11

25 25

16 1714

21

7

Composition by marital status

% of men by marital status, 1965 – 2001

Increased proportion single and divorcedSmaller proportion married or widowed

0

10

20

30

40

50

60

Single Married Divorced Widow ed

1965

1981

2001

Composition by marital status (3)

Marital status by age group, MEN, 2001

0102030405060708090

100

Single

Married

Divorced

Widowed

Composition by marital status (4)

Marital status by age group, WOMEN, 2001

0102030405060708090

100

Single

Married

Divorced

Widowed

Composition by relation with others

Total population, 1961 – 2001

Increase in single with or without childrenDecrease in married with or without childrenSimilar situation for men and women separately

05

101520253035404550

single w ithoutchildren

single w ithchildren

marriedw ithoutchildren

married w ithchildren

1961

1981

200117

34

7 12

3024

46

30

Elderly people

% of HH having elderly person living with them

Decrease between 1970 and 2001

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

1970 1981 1998 1999 2001

Elderly people (2)

Living situation of elderly people in 199163.48

40.43

5.91.3 1.6 1.2

24.6

6.71.0

7.01.7

32.1

0

10

20

30

40

50

60

70

Alone Together Withparents(in law)

withchildren

with non-relatives

othersituation

65-74

75+

Participation rates

Participation rates, MEN, by age group, 1947-2050

Reversed U shape curveDecrease between 1947 and 2050, especially youngest and

oldest age groups

0

10

20

30

40

50

60

70

80

90

100

15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-99

1947

2050

Participation rates (2)Participation rates, WOMEN, by age group, 1947-2050

Shape curve has changed from flat to reverse U-shape Increase between 1947 and 2050 except youngest and oldest

age groups

0102030405060708090

100

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-99

1947

2000

2050

Weekly working hours

Average weekly working hours, by gender, 1983-2000

Higher for men (38 in 2000) than women (30)Decrease for women, rather stable for men

30

32

34

36

38

40

Men

Women

Weekly working hours (2)

% of MEN working certain hours a week, 1983-2000

05

10152025303540

1-10 11-20 21-30 31-34 35-36 37-38 39-40 >40

1983

2000

Weekly working hours (3)

% of WOMEN working certain hours a week, 1983-2000

Increase in lowest groups (part time employment!)Decrease in highest age groups

0

5

10

15

20

25

30

35

1-10 11-20 21-30 31-34 35-36 37-38 39-40 >40

1983

2000

Part time employment

PT employment in % of total employment, by gender

Spectacular increase for women (from 5 to 30%)

0

5

10

15

20

25

30

Men

Women

Part time employment (2)

% PT employment by gender and age group, 1999

Much higher for women than for men (all ages)For men, higher in lower and higher age groups

0.010.020.030.040.050.060.0

14-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60+

Male

Female

Reasons for PT employment

Reasons for PT employment,by gender, 2000, % of PT workers giving this as reason

05

101520253035

No

FT

foun

d

Chi

ld c

are

Per

sona

l/fam

ily

No

FT

wan

ted

Oth

er

Res

t

Women

Men

CONCLUSIONS

• Demand for health care increases with age

• Demand for LTC increases with age

• Decrease in supply of formal health care

• Supply of informal health care?

- household composition

- labour market evolutions