Patterns of Long Term Care in 29 European countries: evidence from an exploratory study

Abstract

Background: The challenges posed by the rapidly ageing population, and the increased preponderance of disabled people in this group, coupled with the rising level of public expenditure required to service the complex organization of long term care (LTC) delivery are causing increased pressure on LTC systems in Europe. A pan-European survey was carried out to evaluate whether patterns of LTC can be identified across Europe and what are the trends of the countries along them.

Methods: An ecological study was conducted on the 27 EU Member States plus Norway and Iceland, referring to the period 2003-2007. Several variables related to organizational features, elderly needs and expenditure were drawn from OECD Health Data and the Eurostat Statistics database and combined using Multiple Factor Analysis (MFA).

Results: Two global Principal Components were taken into consideration given that their expressed total variance was greater than 60%. They were interpreted according to the higher (more than 0.5) positive or negative correlation coefficients between them and the original variables; thus patterns of LTC were identified. High alignment between old age related expenditure and elderly needs characterizes Nordic and Western European countries, the former also having a higher level of formal care than the latter. Mediterranean as well as Central and South Eastern European countries show lower alignment between old age related expenditure and elderly needs, coupled with a level of provision of formal care that is around or slightly above the average European level. In the dynamic comparison, linear, stable or unclear trends were shown for the studied countries.

Conclusions: The analysis carried out is an explorative and descriptive study, which is an attempt to reveal patterns and trends of LTC in Europe, allowing comparisons between countries. It also stimulates further researches with lower aggregated data useful to gain meaningful policy-making evidence.Please see related article: http://www.biomedcentral.com/1741-7015/9/124.

Figure 1

Correlation circle of the variables on the two Principal Components (Factor 1 and Factor 2). Beds: beds in institutions; R. inst: recipients in institutions; R. home: recipients at home; Over 80: share of people aged 80 and over; Bad perc. health: self-perception of health as bad or very bad; Act. restr: self-perceived restrictions on activities; LTC Exp.: LTC total expenditure; Soc. benef.: social protection benefits for old age. Numbers represent the corresponding year for each variable.

Figure 2

MFA factorial space.

Figure 3

Dynamic trends of the 29 European countries. Detailed view of the four quadrants of the MFA factorial space.