Long‐term Care: Growing Sector, Multifaceted Systems

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Abstract:

Long‐term care (LTC) is a growing, but relatively small sector in the economy. People older than 65 years of age, especially those aged over 80 years, have the highest probability of receiving LTC services, while women are the main recipients of services. LTC is a labour intensive sector, which is mostly publicly funded. On average, LTC expenditure accounts for 1.5% of GDP across the OECD. Most care is provided by family carers. The LTC workforce (mostly women working part‐time in a majority of countries) is about 1.3% of the total OECD workforce. Over the last ten years, new long‐term care programmes have been implemented in a number of countries, including cash‐for‐care programmes in European countries and the United States, aiming at providing consumers with more choice and control over LTC services. Due to the variety in target groups, governance, provision and workforce, LTC services are often fragmented. The connection with health systems is sometimes poor. The size, benefits, target groups, use, provision, governance and financing of long‐term care differ markedly across countries. This chapter provides an overview of the sector in OECD countries. It begins by defining long‐term care. In the following sections, it offers a snapshot of who uses, provides, and pays for long‐term care services. Another section describes available services, with a focus on cash‐for‐care programmes, while the final section offers a short overview of recent policy developments in the sector.

Document Type: Review Article

Publication date: May 1, 2011

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