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OECD Health Policy Studies
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Providing and Paying for Long-Term Care
Francesca Colombo, Ana Llena-Nozal, Jérôme Mercier, Frits Tjadens. Published by : OECD Publishing , Publication date:  03 Jun 2011
Pages: 328 , Language: English
Version: Print (Paperback) + PDF
ISBN: 9789264097582 , OECD Code: 812011031P1
Price:   €75 | $105 | £67 | ¥9700 | MXN1350 , Standard shipping included!
Availability: Available (Print on Demand)
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Other languages:  French (Available)
Other Versions:  E-book - PDF Format
Multilingual summaries:  Italian, English

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Tables: 24  Charts: 106 


This book examines the challenges countries are facing with regard to providing and paying for long-term care. With populations ageing and the need for long-term care growing rapidly, this book looks at such issues as: future demographic trends, policies to support family carers, long-term care workers, financing arrangements, long-term care insurance, and getting better value for money in long-term care. 


“WHO recognizes that long-term care represents a major challenge for all countries in the world, with important implications for economic development and for the health and well-being of older people. This well-documented book provides a comparative analysis of the common challenges and diverse solutions OECD countries are adopting to respond to the growing demand for long-term care services, and particularly its implications for financing and labour markets.  It provides much needed evidence to guide policy makers and individuals.”

-Dr John Beard, Director, Department of Ageing and Life Course,
World Health Organization


“This carefully researched book offers invaluable data and insights into the organization and financing of long-term care in OECD countries.  The book is an indispensable resource for anyone interested in international long-term care”.

-Dr. Joshua M. Wiener, Distinguished Fellow and Program Director
of RTI’s Aging, Disability, and Long-Term Care Program, United States

Table of contents:

Executive Summary
Summary and Conclusions
Chapter 1. Long-term Care: Growing Sector, Multifaceted Systems
1.1. Scope of this report: How do OECD societies address the growing need for long-term care?
-1.2. What is long-term care?
-1.3. Who uses formal LTC services?
-1.4. Who provides long-term care?
-1.5. Who pays for long-term care, in what settings and at what cost?
-1.6. What services are provided?
-1.7. How did countries get here? Where are they going? 
-1.8. Conclusions
Chapter 2. Sizing Up the Challenge Ahead: Future Demographic Trends and Long-term Care Costs
2.1. Future demographic trends: Growing LTC demand
-2.2. The pool of family carers is likely to decrease
-2.3. How much will long-term care cost?
-2.4. Conclusions: Policies to address future pressures on long-term care systems
Chapter 3. The Impact of Caring on Family Carers
3.1. Addressing caring responsibilities: The impact on informal carers
-3.2. Most carers are women, care for close relatives and provide limited hours of care
-3.3. High-intensity caring can lead to reduced rates of employment and hours of work
-3.4. For those of working age, caring is associated with a higher risk of poverty
-3.5. Intensive caring has a negative impact on mental health
-3.6. Conclusions
-Annex 3.A1. Data Sources
-Annex 3.A2. Additional Figures
-Annex 3.A3. Estimating the Impact of Caring on Work Characteristics of Carers
-Annex 3.A4. How to Measure the Impact of Caring on Wages
Chapter 4. Policies to Support Family Carers
4.1. Improving carers’ role and wellbeing
-4.2. Helping carers combine caring responsibilities with paid work
-4.3. Improving carers’ physical and mental wellbeing
-4.4. Compensating and recognising carers
-4.5. Conclusions
-Annex 4.A1. Summary Table: Services for Carers
-Annex 4.A2. Leave and Other Work Arrangements for Carers
-Annex 4.A3. Financial Support for Carers .
Chapter 5. Long-term Care Workers: Needed but Often Undervalued
5.1. How many long-term care workers are there?
-5.2. Who are the LTC workers?
-5.3. What are the working conditions in long-term care?
-5.4. Foreign-born workers play a substantial and growing role in some countries
-5.5. Changes in LTC policies affect LTC labour markets
-5.6. Conclusions
Chapter 6. How to Prepare for the Future Long-term Care Workforce?
6.1. The future challenge for the long-term care workforce
-6.2. Improving recruitment and retention: Overview of national policies
-6.3. Ensuring an adequate inflow of long-term care workers
-6.4. Improving retention: Valuing work, building careers
-6.5. Increasing productivity among LTC workers?
6.6. Conclusions
Chapter 7. Public Long-term Care Financing Arrangements in OECD Countries  
7.1. Collective coverage of long-term care costs is desirable on efficiency and access grounds
-7.2. Public long-term care coverage for personal care can be clustered in three main groups
-7.3. Even within universal systems, the comprehensiveness of coverage can vary significantly
-7.4. Different approaches but similar directions: Universalism and choice-based models
-7.5. Conclusions
Chapter 8. Private Long-term Care Insurance: A Niche or a “Big Tent”?
8.1. A small number of OECD countries account for the largest markets
-8.2. Market failures and “consumers myopia” explain why the private LTC insurance is small
-8.3. Policy and private-sector initiatives to increase take up
-8.4. Conclusions: Private long-term care insurance has some potentials but is likely to remain a niche product
Chapter 9. Where To? Providing Fair Protection Against Long-term Care Costs and Financial Sustainability
9.1. Why provide financial protection against long-term care cost?
-9.2. Improving protection against catastrophic care cost calls for universal LTC entitlement
-9.3. Universal care does not exclude targeting: What benefits and for whom?
-9.4. Board and lodging costs in institutions are the main costs that LTC users face
-9.5. Matching care need with finances: Policies for the future
9.6. Conclusions
Chapter 10. Can We Get Better Value for Money in Long-term Care?
10.1. What is value for money in long-term care?
-10.2. Towards more efficient delivery of long-term care
-10.3. Is it possible to optimise health and care?
-10.4. Addressing long-term care systems governance
-10.5. Conclusions

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