2012年-CEPS欧洲政策研究中心_Availability_and_Choice_of_Care_9页_129kb

Summary of ENEPRI Policy Brief No. 9: "Availability and Choice of Care"

Core Content

This policy brief explores the availability and choice of long-term care (LTC) in the European Union, focusing on both informal and formal care provision. It is based on the ANCIEN project, which aims to assess the future of LTC for the elderly in Europe, considering demographic, economic, and policy-related factors.

Main Viewpoints

• Population Ageing and Budget Cuts: The increasing elderly population and reduced national budgets in EU member states are creating significant challenges for both citizens and governments in providing LTC.

• Caregiver Burden: Informal care, often provided by family members, is a crucial source of LTC in Europe. However, it can lead to negative consequences for caregivers, such as reduced wages, stress, and difficulty maintaining employment.

• Variation in Care Provision: There is substantial variation in the availability of informal care across EU countries. Countries like Sweden have lower availability compared to Belgium and the Netherlands. In contrast, Eastern European and Mediterranean countries show higher informal care provision.

• Gender and Education: Women are the primary informal caregivers in most EU countries, and higher education levels are associated with lower informal care use in some countries like Spain and Poland.

• Formal Care Use: The Netherlands has the highest probability of formal care usage, while Spain has the lowest. The use of formal care is influenced by age, physical limitations, and socioeconomic status.

• Interdependence of Care Types: The relationship between formal and informal care is complex. While some countries show evidence of complementary or task-specific care models, others do not exhibit significant interdependence.

• Labour Market Implications: Caregiving responsibilities can lead to labor market constraints for informal caregivers. Women and those caring for adults are more likely to experience such constraints. Countries with better LTC systems, like Germany and Denmark, show less vulnerability to labor problems.

Key Information

1. Informal Care Characteristics

• Availability: Informal care availability varies across countries. For example, Sweden has 34 potential caregivers per 100 people aged 65+, while Belgium and the Netherlands have double that number.
• Providers: The majority of informal care is provided by partners (57-83%) and children (12-41%) of the dependent person.
• Gender: Over 50% of informal caregivers are women in most EU countries, with a higher proportion of women in home-based care in the Netherlands and domestic care in Germany and Spain.
• Education and Income: In Germany and the Netherlands, higher income is associated with greater informal care provision. In Spain and Poland, higher education is linked to lower informal care use.

2. Formal Care Characteristics

• Demand: Women, people with ADL/IADL limitations, those living alone, and individuals with higher education have a higher probability of using formal care.
• Supply: Formal care employment has increased significantly in Spain, Germany, and the Netherlands, with notable growth in the 1993–2008 period. In contrast, Poland is projected to see a reduction in the share of LTC workers.

3. Interdependence of Care Types

• Models: The task-specific and complementary models are supported in Spain and Italy. However, no significant interdependence is observed in Germany and the Netherlands.
• Country Clusters: Based on the structure and generosity of LTC systems, the EU is divided into four clusters:
  • Cluster 1: Belgium, the Czech Republic, Germany, Estonia, and Slovakia
  • Cluster 2: Denmark, the Netherlands, and Sweden
  • Cluster 3: Spain, France, Austria, Slovenia, Finland, and the UK
  • Cluster 4: Italy, Hungary, and Poland

4. Labour Market Implications

• Constraints on Caregivers: Informal caregivers often face constraints in their labor participation, especially in countries where the LTC system is less developed.
• Country Differences: Countries like Germany and Denmark have implemented policies that help caregivers balance work and care, reducing labor market problems.

5. Policy Recommendations

• Support for Caregivers: Policies should support both formal and informal care provision, ensuring quality and sustainability.
• Formal Care Expansion: Formal care should be expanded to reduce the burden on informal caregivers, especially in countries where the conflict between work and care is more evident.
• Regulatory Focus: Regulation should be designed to allow caregivers to maintain employment while fulfilling care responsibilities.
• Technology and Innovation: The role of technology in LTC should be considered, especially in the context of changing care needs and system performance.

Methodological Aspects

• Data Sources: The analysis uses data from the SHARE database, Eurobarometer, Eurostat, and national databases such as the Health 2000 database in Finland, EDAD in Spain, and LTC Insurance registers in Germany.
• Clustering: Countries are clustered based on the structure and generosity of their LTC systems.
• Projections: A stock-flow cohort projection method is used to forecast LTC employment trends across the EU.

Conclusion

The policy brief highlights the importance of understanding the interplay between formal and informal care in the context of aging populations and changing labor market dynamics. It advocates for a balanced and sustainable LTC system that supports both caregivers and care recipients, emphasizing the need for policy interventions that address the specific needs and challenges of different countries.