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. 2018 Jun;46(4):436-447.
doi: 10.1177/1403494817726197. Epub 2017 Aug 21.

How to understand informal caregiving patterns in Europe? The role of formal long-term care provisions and family care norms

Ellen Verbakel  1
Affiliations

How to understand informal caregiving patterns in Europe? The role of formal long-term care provisions and family care norms

Ellen Verbakel. Scand J Public Health. 2018 Jun.

Abstract

Aims: Motivated by ageing populations, healthcare policies increasingly emphasize the role of informal care. This study examines how prevalence rates of informal caregivers and intensive caregivers (i.e. those who provide informal care for at least 11 hours a week) vary between European countries, and to what extent informal caregiving and intensive caregiving relate to countries' formal long-term care provisions and family care norms.

Methods: Multilevel logistic regression analyses on data from the European Social Survey Round 7 ( n = 32,894 respondents in n = 19 countries) were used to test (a) contradicting hypotheses regarding the role of formal long-term care provisions based on crowding-out, crowding-in and specialization arguments and (b) the hypothesis that strong family care norms are positively related to (intensive) informal caregiving.

Results: Prevalence rates of informal caregiving varied between European countries, from 20% to 44%. Intensive caregiving ranged from 4% to 11%. Opposite patterns regarding the role of formal long-term care provisions were revealed: generous long-term care provisions in a country were related to a higher likelihood of providing informal care, but a lower likelihood of providing intensive care. Moreover, intensive caregiving was more likely when family care norms in a country were strong.

Conclusions: This study provided support for the specialization argument by showing that generous formal long-term care provisions crowded-out intensive caregiving, but also encouraged more people to provide (some) informal care. Because especially intensive caregiving is burdensome, low levels of formal long-term care provisions might bring risks to caregivers' well-being and healthcare systems' sustainability.

Keywords: European Social Survey; Informal caregiving; ageing; care norms; cross-country comparison; crowding-out; family norms; formal care; intensive caregiving; long-term care.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Countries by their proportions of informal and intensive caregivers.
Figure 2.
Figure 2.
Marginal predicted probabilities of generosity of long-term care provisions and family care norms on (intensive) informal caregiving.a aOther variables kept at their mean. x-axis is in standard deviations from the mean; y-axis are probabilities.
See this image and copyright information in PMC

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