Long-term care (LTC)

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LTC Data | LTC policies | Publications | Contact

The Health Division examines challenges affecting long-term care systems, focusing particularly but not solely, on the elderly population. Population ageing and a growing number of dependent elderly will put upward pressure on the demand for and cost of LTC services in the future. Meanwhile, societal transformation will reduce the supply of care provided by informal caregivers, while growing workforce shortages will endanger the capacity of health and social care systems to supply care. Work on long-term care involves both data strengthening and analysis of policies.

Strengthening data on long-term care systems

OECD Health Data 2008 has a chapter on long-term care resources and utilisation, including data on number of beds in nursing homes and on recipients of long-term care services.

Revisions to the definition and estimation methods of long-term care expenditure are a key component of the process of revision of the System of Health Accounts (SHA) manual. This process, jointly coordinated by OECD, Eurostat and WHO, aims at improving the policy relevance and comparability of LTC expenditure data, as well as feasibility of the estimation methods. A report, Conceptual Framework and Methods for Analysis of Data Sources for Long-Term Care Expenditure, begins to refine the definition methodology to improve the availability and comparability of long-term care expenditure data.

Long-term care policies

The OECD has analysed long-term care policies for older people in a 2005 comparative report.

Since then, different projects have examined the demand for and the supply of long-term care.

Disability trends

The OECD undertook a study in 2005-06 to assess disability trends among elderly people in a number of OECD countries and the implications for the future number of elderly people who might need long-term care. The study had three main objectives:

• To monitor the most recent trends on the prevalence of severe disability among people aged 65 and over in a dozen OECD countries (Australia, Belgium, Canada, Denmark, Finland, France, Italy, Japan, the Netherlands, Sweden, the United Kingdom and the United States);
• To gather complementary information on factors (both medical and non-medical) that might be driving changes in elderly disability rates over time in these countries;
• To make some projections on the future number of elderly people who may be severely disabled in these 12 countries, based on different scenarios.

The final report, Trends in Severe Disability Among Elderly People: Assessing the Evidence in 12 OECD Countries and the Future Implications (Health Working Paper No. 26), was released in March 2007. 

Healthy Ageing Policies

A review of current policies to prevent the onset of old-age disability, or so-called “healthy ageing policies” was released in February 2009 as OECD Health Working Paper No. 42. This paper identifies four different groups of policies: i) working longer and promoting social integration; ii) improving lifestyles; iii) adapting health care systems to the needs of the elderly; and iv) attacking underlying social/environmental factors affecting healthy ageing.

Addressing human resources for long-term care

A study on balancing long-term care needs with human resources  was released in March 2009. Drawing from selected countries’ experience, the study addresses the needs for building adequate capacity for provision of long-term care, as well as challenges related to workforce shortages and migration.

2009-2010 Work Programme: Selected issues in long-term care in OECD countries

Two main issues will be addressed by the OECD in the area of long-term care: 

• Long-term care workforce and addressing caring responsibilities
• New social insurance models for addressing long-term care financing and sustainability

Publications

Several OECD studies have addressed the implications of population ageing for health and long-term care over the past few years. These include:

• The Long-Term Care Workforce: Overview and Strategies to Adapt Supply to a Growing Demand (OECD Health Working Papers No. 44)
• Policies for Healthy Ageing: An Overview (OECD Health Working Papers No. 42)
• Conceptual Framework and Methods for Analysis of Data Sources for Long-Term Care Expenditure
• Trends in Severe Disability Among Elderly People: Assessing the Evidence in 12 OECD Countries and the Future Implications (OECD Health Working Papers No. 26)
• OECD Health and Long-term Care Expenditures: What are the main drivers? (Economics Department Working Papers No.477)
• Long-term Care for Older People, (OECD, 2005)
• Long-term Care for Older People - Policy Brief
• Consumer Direction and Choice in Long-Term Care for Older Persons, Including Payments for Informal Care: How Can it Help Improve Care Outcome, Employment and Fiscal Sustainability? (OECD Health Working Papers No. 20)
• Dementia Care in 9 OECD Countries: A Comparative Analysis (OECD Health Working Papers No. 13)
• Stroke Care in OECD Countries: a comparison of treatment, costs and outcomes in 17 countries  (OECD Health Working Papers No. 5)
• Policies for an Ageing Society: recent measures and areas for further reform (Economics Department Working Paper No. 369)
• Ageing, Housing and Urban Development (OECD, 2003)
• Care Allowances for the Frail Elderly and their Impact on Women Care-Givers (Labour Market and Social Policy Occasional Paper No. 41)
• Reforms for an Ageing Society (OECD, 2000)
• Ageing and Care for Frail Elderly Persons: an overview of international perspectives (Labour Market and Social Policy Occasional Paper No. 38)
• The Health of Older Persons in OECD Countries: Is it improving fast enough to compensate for population ageing? (Labour Market and Social Policy Occasional Paper No. 37)

Contact

Ms. Francesca Colombo (tel: +33 1 45 24 93 60 or francesca.colombo@oecd.org)