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ANCIEN. Overview of ANCIEN and classification of long-term care systems Esther Mot (Netherlands Bureau for Economic Policy Analysis, CPB), Peter Willem é (Federal Planning Bureau) iHEA, 8th World Congress on Health Economics , Toronto, July 10-13 2011. Long-term care for the elderly.
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ANCIEN Overview of ANCIEN and classification of long-term care systems Esther Mot (Netherlands Bureau for Economic Policy Analysis, CPB), Peter Willemé (Federal Planning Bureau) iHEA, 8th World Congress on Health Economics, Toronto, July 10-13 2011
ANCIEN, general information • Assessing Needs of Care in European Nations • research for EC in 7th Framework Programme • January 2009 – August 2012 • 21 EU-countries included
Typologies of LTC systems Results of Work package 1 • managed by Institute for Advanced Studies, Vienna • typology report: Kraus, M., M. Riedel, E. Mot, P. Willemé, G. Röhrling, T. Czypionka (2010), A typology of systems of Long-Term Care in Europe
ANCIEN, objectives • describe and characterise systems of LTC in Europe • analyse the need for care (in relation to demography and lifestyle) • analyse developments in the supply and demand for formal and informal care • analyse the potential role of technology in solving LTC problems
ANCIEN, objectives continued • analyse efforts to improve the quality of LTC • project the use of LTC on the basis of developments in need and supply • evaluate the performance of different types of LTC systems
Aims of Work Package 1 • description of LTC-systems in Europe • development of typologies • designed for analysis of LTC systems (as opposed to more general welfare state typologies) • selection of countries to model • needs (demography, lifestyle) • supply (formal and informal) • use of care
WP1, steps • data on LTC collected by national experts • standardised format • problems with data collection • country reports • typologies
Characteristics for typology Who carries the most responsibility for LTC: formal system or family/person?: • public spending on LTC • private spending on LTC • role of formal versus informal care • support for informal care givers • is there an entitlement? • how strict are eligibility criteria?
Characteristics for typology, 2 • How is formal system organised: • quality assurance • type of providers • centralised or not? • coordination and integration of care • What about freedom of choice? • role of cash benefits? • free choice of providers?
WP1, two methods of clustering • mostly organisational, 21 countries • for example choice of provider, quality assurance • use and financing of care, 14 countries
Use and financing typology • selection of 8 metric variables for 14 countries • factor analysis on 8 variables, 4 variables used • cluster-analysis
Variables • public spending* (related to GDP and needs) • share of private expenditures* • informal care use* • IC support* • formal care use • role of cash benefits • accessibility • targeting
Countries to be modelled (considering data availability) • Germany • the Netherlands • Spain • Poland (simplified models)
Conclusion • most new member states only to be analysed with organisational approach, but NMS not in 1 cluster (in both typologies) • 3 variables crucial for countries with better data: • needs-corrected public spending, private funding, informal care support
Conclusion 2 • stable clustering of Nordic countries with generous systems with large role for formal care (under different approaches): • Sweden, Denmark, Netherlands • important role for informal care in all other clusters • distinction by private financing, IC support, use of formal care, role of cash benefits
Conclusion 3 • large impact of available information • different clustering with richer dataset • clustering especially for LTC is different
More information: • http://www.ancien-longtermcare.eu/ • general information • country reports on LTC systems • typology report • kraus@ihs.ac.at (Institute for Advanced Studies) • mot@cpb.nl (CPB) • pw@plan.be (FPB)