As populations around the world age, demand for long-term care (LTC) is likely to increase, making it difficult for governments to balance financial sustainability with the need to provide effective protection against the financial risks associated with LTC needs.
How do different long-term care systems fare in protecting older persons from high costs and the risk of poverty? How much of countries’ spending on long-term care actually helps older people to pay for the often substantial costs of services? And how can adequate protection and financial sustainability be balanced? These questions are not easy to answer, but in a common effort the OECD and the EC provide insights in how different models of organising long-term care perform in terms of achieving social protection.
To discuss how this effort can be further strengthened, EU countries came together on several occasions in November and December 2023. In addition to a mutual learning workshop organised in Brussels, countries also exchanged about possible ways forward during a virtual workshop. Discussions centred on how the long-term care systems could be represented even better by including more care settings and more levels and kinds of LTC needs. Participants also debated how to improve the data collection to estimate the cost of long-term care and how the generosity of long-term care systems relates to other system characteristics.
Use the drop-down lists below to compare social protection for LTC in old age in countries and subnational areas of the EU and the OECD, for different levels of needs (low, moderate and severe) and different care settings (home care and institutional care).
TOTAL COSTS OF CARE
Total costs of long-term care can be very high compared to median disposable income in old age.
Total costs of care as a share of median disposable income of over 65-year olds
Note: National median disposable incomes are for people of retirement age or older (e.g. the costs of long-term care in South Tyrol are compared to the national median disposable incomes in Italy). Severe needs correspond to 41.25 hours of care per week. Older person with severe needs receiving long-term care at home is assumed to live with a spouse who can provide 24- hour supervision, help with taking medicines, and manage the finances, but cannot provide care for any other activities of daily living and instrumental activities of daily living.
|FINANCIAL PUBLIC SUPPORT
Financial public support for the total costs of long-term care varies widely.
Share of total long-term care costs that would be covered by public social protection systems, for care recipients earning a median income and holding no net wealth, by severity and care setting
Note: Low, moderate and severe needs correspond to 6.5, 22.5 and 41.25 hours of care per week, respectively.
Out-of-pocket costs of long-term care can represent a significant share of median disposable incomes in old age.
Out-of-pocket costs of long-term care as a share of old age median disposable income after public support, for care recipients holding no net wealth, by severity of needs and care setting
Note: Low, moderate and severe needs correspond to 6.5, 22.5 and 41.25 hours of care per week, respectively. Low income is the upper boundary of the 20th percentile of income and high income is the upper boundary of the 80th percentile of income, both among people of retirement age or older.
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