Integration and efficiency in complex and long-term care …..

1. Integration and efficiency in complex and long-term care ….. Prof. Dr. Guus Schrijvers Denmark, januari 2010

2. I want to present to you: • We carried out a preliminary study on the accessibility, care allocation, and assessment of long term care in seven European countries. • What are the theme’s in the public debate in those countries, we asked ourselves en what can we learn from their practices? • In this presentation I present to you some observations with the emphasis on the financial sustainability of the LTC.

3. Development of the systems. 50 years ago, long term care was everywhere generally a private responsibility. A responsibility of the family, the local community and as a matter of last resort, of charity. Long term care is now everywhere, direct or indirect a mayor public responsibility. They are the product of the political en social history of the seven countries. In the Netherlands from 0% in 1945 tot 3.4 % of BNP in 2008.

4. AWBZ: % of GNP

5. Themes in the countries surveyed.

6. Accessibility of care, care assessment and care providing. In all of the seven countries the accessibility to LTC is an important theme in the public debate. We see a tendency to introduce elements of a demand driven system in all seven countries.

7. Accessibility of care, care assessment and care providing.

8. Accessibility of care, care assessment and care providing.

9. Strengthening of the autonomy and empowerment. • In all countries we see initiatives and debates aimed to empower the position and strengthen the autonomy of people in need of LTC. • We see the public function gradually changing from a supply orientated and care providing role to a more supporting role, whereby people are enabled and supported to solve their problems in their own way and to their own preferences.

10. Growths of positive care assessments in the Netherlands. Bron: CIZ trendrapportages 2008

11. Number of positive assessments. Relative increase 2005-2008 Total: 33% supplies standard care 28% personal budget 116% SSC + PB 112%

12. How to integrate care, social participation and welfare. Chronisch zieke moet kunnen meedoen Door in te zetten op een ketenzorg voor chronisch zieken streeft het kabinet naar winst voor individu en arbeidsmarkt, schrijven de ministers Piet Hein Donner en Ab Klink. Now there are 4.5 million people with chronically diseases, in 15 year 30% more:

13. How to integrate care, social participation and welfare.

14. The financial sustainability of long-term care. • Financing long term care is expected to be a growing problem in all these countries,causes including:

15. The financial sustainability of long term care.

16. The financial sustainability of long-term care.

17. Development of a three tier system. • People in need of care (and/or their social environment) organize and finance their own care. • People receive forfeiture means, like allowances, tax reductions, insurance means in order to keep their lives going tot their own preferences. for some people this will not be sufficient therefore: • They make a plan of their future with element as education, work, transport, income and care and they receive a integrated budget, with enables them to carry out that plan. (France, pilots in Germany and England).

18. A three tier system.

19. I thank you for your attention!! Guus Schrijvers http://www.integratedcare.eu/integratedcare_ned/downloads/090905laatste-30-juli.pdf