2012年-CEPS欧洲政策研究中心_Executive_Summary_of_Work_Package_3_on_Availability_and_Choice_of_Care_of_the_ANCIEN_Project_14页_186kb

Executive Summary of Work Package 3 on Availability and Choice of Care of the ANCIEN Project

Core Content

Work Package 3 (WP3) of the ANCIEN project focuses on the availability and choice of long-term care (LTC) across European countries. The objective is to document the factors influencing the decision between formal and informal care and to explore how these choices are shaped by institutional settings. The research is conducted by seven partner institutes, each contributing to specific tasks related to the supply and demand of care, the burden on caregivers, and the implications for the labour market.

Main Tasks and Contributions

1. Task 1: Informal Care Supply and Regulation

• IHS provides a comprehensive overview of informal care across 21 EU countries, highlighting the role of regulation, decentralisation, and service characteristics.
• CASE investigates the determinants of informal care demand in four countries (Netherlands, Germany, Spain, and Poland/Italy), identifying factors such as health status, age, and education.
• LSE uses Eurobarometer data to examine the probability of informal care provision, noting that informal care is more common in Eastern and Southern Europe, especially for those with fewer ADLs.

2. Task 2: Formal Care Supply and Regulation

• IHS analyses the formal care supply, including access, quality, and service types, across 21 countries.
• CASE compares formal care usage across the same four countries, showing that formal care is more prevalent in the Netherlands and less so in Spain.
• LSE further explores the characteristics of formal care systems, revealing that the Netherlands and Germany have lower informal care provision despite higher formal care needs.

3. Task 3: Determinants of Care Type Choice

• FEDEA develops a model using SHARE data to examine the probability of receiving formal, informal, or both types of care. It finds that in Spain and Italy, the choice of care is influenced by the task-specific and complementary models, whereas in Germany and the Netherlands, these choices are less interrelated.
• The model also suggests that the type of care received is more dependent on the dependent person's needs than on country-specific utility characteristics.

4. Task 4: Burden of Caregivers and Policy Impact

• FEDEA analyses the burden of informal caregivers and the impact of unmet needs in formal care on their labour market outcomes.
• It identifies three groups of countries based on the relationship between unmet needs and labour problems:
  • Group 1: 11 countries (e.g., Germany, Italy, Poland) where informal care acts as a substitute for formal care.
  • Group 2: 7 countries (e.g., Denmark, France, Turkey) where unmet needs have a lower impact on labour problems.
  • Group 3: 11 countries (e.g., Spain, Netherlands, Croatia) where informal caregivers face significant challenges in maintaining their employment due to care responsibilities.

5. Task 5: Labour Market Implications of Caregiving

• ISAE uses ECHP data to assess the impact of LTC on caregivers' labour market participation.
• It finds that women, especially those not working or caring for adults in their own household, are more likely to experience constraints in their paid work due to caregiving responsibilities. The burden increases with age and intensity of care.

Key Findings

• Informal care is more prevalent in countries with less developed formal care systems, particularly in Southern and Eastern Europe.
• Formal care is more likely to be used by women, individuals with health limitations, those living alone, and those with higher education.
• Institutional settings significantly influence care choices. Countries with more developed formal care systems see higher formal care usage.
• Labour market constraints are a major burden for informal caregivers, especially in countries where formal care is limited or unmet needs are common.
• Unmet needs in formal care lead to increased reliance on informal care and greater difficulties in maintaining employment.
• Demographic trends are projected to have a substantial impact on LTC workforce size, with Spain expected to see a doubling of care workers, while Poland may experience a halving.

Concluding Comments

The findings from WP3 highlight the complex interplay between institutional frameworks, care supply, and individual and family characteristics in shaping care choices across Europe. The report underscores the importance of aligning LTC policies with demographic and health trends and suggests that country-specific policies may be necessary to address unique challenges in care provision and caregiver burden. The analysis also points to the need for better integration of formal and informal care systems to reduce the strain on caregivers and improve overall care quality and accessibility.