1. ANCIEN Typologies of LTC systems based on use and financing of care Esther Mot (CPB) Peter Willemé (FPB) asisp Annual Network Meeting, March 30, 2011

2. ANCIEN, general information  Assessing Needs of Care in European Nations  research for EC in 7th Framework Programme  January 2009 – August 2012  21 EU-countries included

3. ANCIEN, general information 2  Coordination: Center for European Policy Studies (CEPS): Güldem Okem  Scientific coordination Federal Planning Bureau (FPB): Peter Willemé Netherlands Bureau for Economic Policy Analysis (CPB): Esther Mot  Work package 1 managed by Institut für Höhere Studien, Wien

4. ANCIEN, objectives  describe and characterise systems of LTC in Europe  analyse the need for care (in relation to demography and lifestyle)  analyse developments in the supply and demand for formal and informal care  analyse the potential role of technology in solving LTC problems

5. ANCIEN, objectives continued  analyse efforts to improve the quality of LTC  project the use of LTC on the basis of developments in need and supply  evaluate the performance of different types of LTC systems

6. Work Package 1  description of LTC-systems in Europe  development of typology  selection of countries to model needs (demography, lifestyle) supply (formal and informal) use of care

7. WP1, data collection  data on LTC collected by national experts standardised format problems with data collection  country reports  typologies

8. WP1, two methods of clustering  mostly organisational, 21 countries Means-testing, entitlement Availabilility of cash benefits, choice of provider Quality assurance, coordination Cost-sharing for types of LTC Public expenditure as share of GDP  use and financing of care, 14 countries

9. Use and financing typology  selection of 8 metric variables for 14 countries  cluster-analysis factor analysis on 8 variables, 4 variables used k-means clustering meta-analysis

10. Variables  public spending* (related to GDP and needs)  share of private expenditures*  informal care use*  IC support*  formal care use  role of cash benefits  accessibility  targeting

11. Result

12. Result, by cluster informal care oriented, low private financing Belgium*, Czech Republic, Germany, Slovakia * medium spender low spending, low private, high IC use, high IC support, cash benefits modest generous, accessible and formalized Denmark, the Netherlands, Sweden high spending, low private, low IC use, high IC support, cash benefits modest informal care oriented, high private financing Austria, England, Finland, France, Spain medium spending, high private, high IC use, high IC support, cash benefits high high private financing, informal care seems necessity Hungary, Italy low spending, high private, high IC use, low IC support, cash benefits medium

13. Star plot of LTC systems

14. Organisational typology

15. Comparison of typologies  attractiveness ordering of systems making assumptions on preferences  results similar ordering for 10 countries different for Belgium, France, Germany and Italy extent of private funding can partly explain differences

16. Countries to be modelled (considering data availability)  Germany  the Netherlands  Spain  Poland (?)

17. Comparison of selected countries and Finland Germany Netherlands FinlandSpainPoland cluster12334 (?) public spending % GDP0.92.11.80.50.4 corrected pop. 65+ 0.0460.1460.1110.03 private funding share of total 27% (all ages) 15% (all ages) 28% 21 – 40%

18. Comparison, continued GermanyNetherlandsFinlandSpainPoland informal care use % pop. 65+17.56.715.117NA informal care support benefits and income support 66664 formal care use % pop. 65+6.927.419.97.8NA cash benefits euro, average HBC+FIC, corrected 1294208767296 accessi- bility high low targetinghighmediumNAhigh

19. Conclusion  large impact of available information different clustering with richer dataset  3 variables crucial: needs-corrected public spending, private funding, informal care support

20. Conclusion 2  stable clustering of Nordic countries with generous systems with large role for formal care (under different approaches): Sweden, Denmark, Netherlands  important role for informal care in all other clusters distinction by private financing, IC support, use of formal care, role of cash benefits

21. Conclusion 3  most new member states only to be analysed with organisational approach  low financial generosity for most NMS Latvia and Slovenia exceptions  large differences in organisational depth among NMS

22. More information:  http://www.ancien-longtermcare.eu/ http://www.ancien-longtermcare.eu/ general information country reports on LTC systems typology report: Kraus, M., M. Riedel, E. Mot, P. Willemé, G. Röhrling, T. Czypionka (2010), A typology of systems of Long-Term Care in Europe - Results of Work Package 1 of the ANCIEN Project  mot@cpb.nl (Netherlands Bureau for Economic Policy Analysis) mot@cpb.nl