Long-term care and Disability Trends among Older Populations

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Long-term care for elderly people | Disability trends | Contact | Publications

Long-term care (LTC) for elderly people

Building on past OECD work on long-term care, the Health Division continues to examine the challenges affecting long-term care systems as part of its current programme of work.

This reflects continued policy relevance of long-term care policies for health and social systems across OECD countries. 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. OECD countries adopt different arrangements to finance and provide long-term care services, but all systems essentially respond to  common system objectives of: i) improving quality; ii) ensuring affordability and access to care; iii) enhancing patient orientation; iv) maintaining financial sustainability; and iv) promoting value from money.

Work by the Health Division involves both data strengthening and analysis of policies to help OECD countries address pressures on long-term care systems:

• Strengthening data collection and comparability. The OECD Health Division will include a new module on long-term care recipients in OECD Health Data 2008. This new data collection process builds upon a pilot data collection on long-term care recipients, which had been tested with a large number of member countries in 2005.
• LTC policies. Work involves two main elements: i) a review of current policies to prevent the onset of old-age disability, or “healthy ageing policies”; ii) a study, drawing from selected countries’ experience, on balancing long-term care needs with human resources, addressing the needs for building adequate capacity for provision of long-term care, as well as challenges related to workforce shortages and migration.
• Boundaries between health and social care. Revisions to the definition and estimation methods of long-term care 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.
  

Disability trends

The OECD has undertaken 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.

An initial workshop, jointly hosted by the European Commission and the OECD, on ‘Understanding trends in disability among elderly populations and the implications of demographic and non-demographic factors for future health and long-term care costs’, took place on 21-22 February 2005 in Brussels.
Presentations from this workshop are available online at:
http://europa.eu.int/comm/economy_finance/events/2005/events_brussels_0205_en.htm.
The final report from this project 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. 

Contact

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

Publications

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

• 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)