This report evaluates the performance of long-term care (LTC) systems in Europe, with a special emphasis on four countries that were selected in Work Package 1 of the ANCIEN project as representative of different LTC systems: Germany, the Netherlands, Spain and Poland. Based on a performance framework, we use the following four core criteria for the evaluation: the quality of life of LTC users, the quality of care, equity of LTC systems and the total burden of LTC (consisting of the financial burden and the burden of informal caregiving).

This report considers three case studies (namely diabetes, dementia and obesity) for setting up a framework to assess the systemic influences of technologies in the long-term care milieu, using a problem-driven approach in relation to health care. Such technologies could be an enabling factor or a catalyser of advances taking place in the health and social sectors.

In Germany the majority of people in need of care are living at home with the help of their family and/or professional carers. Admission into a nursing is seen as the last step. Caregiving in nursing homes is required if caregiving at home is not possible due to the absence of an informal carer or cannot be provided to the required degree, in particular if the recipient suffers from mental illnesses or if around-the-clock-care and advice is required.

This study reports on the quality indicators that were collected by the ANCIEN project partners in each country considered in Work Package 5 (Quality in Long-Term Care).

Work Package 2 of the ANCIEN project assesses the future numbers of care-dependent elderly in four selected countries: Spain, Poland, Germany and the Netherlands. The estimates are consistent with the available disability data and the mortality forecasts of the EUROPOP 2008 scenarios. The results show the effects of  assumptions about how old age disability and mortality are related, and assess the effects of smoking and BMI.

This paper describes the quality assurance system for long-term care services in Latvia. Policy planning for long-term care is undertaken by the Ministry of Welfare and the municipalities. Monitoring takes place at three levels: by the ministry, the municipalities and social service providers themselves. The legislation sets out requirements for social service providers and the evaluation of quality standards against a few criteria.

In Austria, the responsibilities for long-term care mainly lie with the provinces, although federal and organisational-level initiative has grown. Quality assurance policies focus overwhelmingly on the health system and are only slowly appearing in the realm of long-term care (LTC). Although the Austrian LTC system is still very fragmented owing to the division of competencies, there are enhanced efforts underway to harmonise LTC provision, standards and quality nationwide.

In Slovenia, the government’s Strategy of Care for the Elderly up to 2010 attempted to introduce a new model to support families with elderly members, new programmes for elderly care with individual solutions and supportive social networks to foster the cohabitation of generations. Yet there is no national, quality management strategy. The most apparent difficulty in gathering data on quality is the fragmentation of long-term care between the health and social care sectors.

Work Package 3 on the Availability and Choice of Care of the ANCIEN project aims to document the forces driving the choice of formal and informal care across European countries and to characterise the linkages between the type of care used by dependent people and a country's institutional setting, which determines the supply of formal and informal care. Different issues related to formal and informal care choices and the LTC (long-term care) institutional setting in the EU have been analysed by the WP3 contributors. This research report summarises each partner’s contribution.

The aim of this report is to identify patterns in the utilisation of formal and informal long-term care (LTC) across European countries and discuss possible determinants of demand for different types of care. It addresses specific research questions on the volume of different types of care and the conditions under which care is provided. The latter include demographic factors, especially population ageing, health status and the limitations caused by poor health, family settings and social networking.

This study seeks to estimate the effects of problems in labour force participation and unmet needs for formal care on informal caregiving. Using information for 2007 from Eurobarometer 283/Wave 67.3 for the EU-27 and the two candidate countries, Turkey and Croatia, we estimate a trivariate probit model dealing with the potential endogeneity of labour force participation problems and unmet needs for formal care. The results suggest that in the context of labour force participation problems, there is also an increased probability of observing unmet needs for formal care.

This report investigates the organisation and provision of long-term care for the elderly population in 21 member states of the European Union, thus including both old as well as new member states. It highlights several aspects regulating long-term care systems, e.g. which level of government is responsible for regulation or for capacity-planning and how access to services is organised. The authors further elaborate on public and private provision of services, and on the possibility of persons in need of care to choose between different care providers or different settings of care.

This ANCIEN project research report provides a comparative analysis of the size and composition of the long-term care (LTC) workforce in four European countries – Germany, the Netherlands, Spain, and Poland – each representative of a different type of LTC system. Trends over the 1993-2008 period show substantial differences in care worker density, with the Netherlands continuing to have the highest number of care workers relative to its older population.

This report summarizes the main results of Work Package 1 of the research project ‘Assessing Needs of Care in European Nations’ (ANCIEN).
This report aims at contributing to knowledge on long-tem care (LTC) system design features by developing a typology of LTC system models in EU countries, which are characterized by diverse arrangements for the provision of care/organization and financing. Its approach deviates from existing typologies in a number of ways: