To What Extent Is Long-term Care Representative of Elderly Care? A Case Study of Elderly Care Financing in Lombardy, Italy

Document Type : Debate

Authors

1 Department of Economics and Finance, Università Cattolica del Sacro Cuore, Milan, Italy

2 CEIS EEHTA (Economic Evaluation & Health Technology Assessment), Università di Roma “Tor Vergata,” Roma, Italy

Abstract

The ageing of European population has been rapidly increasing during the last decades, and the problem of elderly care financing has become an issue for policy-makers. Long-term care (LTC) financing is considered a suitable proxy of the resources committed to elderly care by each government, but the preciseness of this approximation depends on the extent to which LTC is representative of elderly care within each country. Since there is a broad heterogeneity in LTC funding, organization and setting among European States, it is difficult to find a common parameter representing the public resources destined to the elderly care. We address these topics employing as a case study an Italian region, Lombardy, which in terms of population, dimension, healthcare organization and economic development could be compared to other European countries. The method we suggest, which consists basically in a careful estimate of all the public resources employed in the provision of services exclusively destined to the elderly, could be applied, with the due differences, to other European countries or regions.

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Main Subjects


  1. European Commission: Adequate social protection for long-term care needs in an aging society. Report jointly prepared by the Social Protection Committee and the European Commission Services. http://ec.europa.eu/health/ageing/docs/ev_20140618_co04_en.pdf. Accessed July 30, 2016. Published 2014.
  2. Lipszyc B, Sail E, Xavier A. Long-term care: need, use and expenditure in the EU-27. European Commission Economic Papers no. 469. http://ec.europa.eu/economy_finance/publications/economic_paper/2012/pdf/ecp469_en.pdf. Accessed July 30,  2016. Published 2012.
  3. Eurostat: Population and population change statistics.  http://ec.europa.eu/eurostat/statistics-explaineips/index.php/Population_and_population_change_statistics.  Accessed July 30, 2016. Published 2015.
  4. Crespo L, Mira P. Caregiving to elderly parents and employment status of European mature women. Rev Econ Stat. 2010;96(4):693-709. doi:10.1162/REST_a_00426
  5. Bacx P. Financial Incentives in Long-Term Care. http://repub.eur.nl/pub/78058. Accessed July 30,  2016. Published 2015.
  6. The 2015 Ageing Report. Underlying Assumptions and Projection Methodologies. European Commission;  2014.
  7. Piculescu V, Elia L, Becker W. Survey of Simulation Models of Long-Term Care Use and Expenditure. Joint Research Centre Technical Report.  https://core.ac.uk/download/pdf/38625328.pdf. Accessed July 30, 2016. Published 2012.
  8. OECD. Public Long-term Care Financing Arrangements in OECD Countries. In: Help Wanted? Providing and Paying for Long-Term Care. OECD; 2011. http://www.oecd.org/els/health-systems/help-wanted-9789264097759-en.htm.  Accessed July 30, 2016.
  9. Costa Font J. Sharing lessons from Europe in financing and delivery of long term support services. The Journal AARP. Spring 2013.
  10. Riedel M, Kraus M. The organization of formal long-term care for the elderly: Results from the 21 European country studies in the ANCIEN project. https://www.files.ethz.ch/isn/134198/RR%20No%2095%20_ANCIEN_%20Organisation%20of%20Formal%20LTC.pdf.  Accessed July 30, 2016. Published 2011.
  11. Brenna E, Di Novi C. Is caring for older parents detrimental to women’s mental health? The role of the European North-South gradient. Rev Econ Househ. 2016;14(4):745-778. doi:10.1007/s11150-015-9296-7.
  12. Bettio F, Plantenga J. Comparing care regimes in Europe. Fem Econ. 2004;10(1):85-113.
  13. Esping-Andersen G. The Three Worlds of Welfare Capitalism. London: Polity: 1990.
  14. Eggink E, Woittiez I, Ras M. Forecasting the use of elderly care: a static micro-simulation model. Eur J Health Econ. 2016;17(6):681-691. doi:10.1007/s10198-015-0714-9
  15. Busse R, Blümel M, Scheller-Kreinsen D, Zentner A. Tackling chronic disease in Europe Strategies, interventions and challenges. http://www.euro.who.int/en/health-topics/Life-stages/healthy-ageing/publications/2010/tackling-chronic-disease-in-europe-strategies,-interventions-and-challenges-2010.   Accessed July 30, 2016. Published 2010.
  16. Wong A, van Baal PH, Boshuizen HC, Polder JJ. Exploring the influence of proximity to death on disease-specific hospital expenditures: a carpaccio of red herrings. Health Econ. 2011;20(4):379-400. doi:10.1002/hec.1597
  17. Sirven N, Rapp T. The cost of frailty in French. Eur J Health Econ. 2016. doi:10.1007/s10198-016-0772-7.
  18. Istituto Nazionale di Statistica (Istat): Bilancio demografico nazionale. http://www.istat.it/it/archivio/186978.  Accessed July 30, 2016. Published 2015.
  19. Brenna E. Quasi-market and cost-containment in Beveridge systems: the Lombardy model of Italy. Health Policy. 2011;103(2-3):209-218. doi:10.1016/j.healthpol.2011.10.003
  20. OECD: Health at a Glance 2015. OECS Indicators. http://www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm.   Accessed July 30, 2016. Published 2015.
  21. Regione Lombardia: Bilancio Sociale. Published 2009.
  22. Italian Ministry of Finance Report: Medium-long term’ trends of the retirement, social and Healthcare’ systems. Report n° 16. 2015.
  23. Regione Lombardia: Piano degli indicatori e dei risultati attesi di bilancio. http://www.consiglio.regione.lombardia.it/piano-degli-indicatori.  Accessed July 30, 2016. Published 2015.
  24. Istat, Istituto Nazionale di Statistica. http://www.istat.it/it/anziani/popolazione-e-famiglie. Accessed July 30, 2016.
  25. Istat, statistiche della previdenza e dell’Assistenza sociale, i beneficiari delle prestazioni pensionistiche. http://www.istat.it/it/archivio/115101. Accessed July 30, 2016.
  • Receive Date: 07 November 2016
  • Revise Date: 14 February 2017
  • Accept Date: 14 February 2017
  • First Publish Date: 01 August 2017