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From care in homes to care at home: European experiences with (de)institutionalisation in long-term care
- Authors:
- ILINCA Stefania, LEICHSENRING Kai, RODRIGUES Ricardo
- Publisher:
- European Centre for Social Welfare Policy and Research
- Publication year:
- 2015
- Pagination:
- 15
- Place of publication:
- Vienna
Many countries across Europe have developed strategies to support community-based services in an attempt to replace traditional institutional models of care. Differences in needs, approaches and commitment levels have led to diverse results and pace of progress. However, much can be learned from their experiences and from examples of strategies and models which proved to be effective. This Policy Briefing presents a typology of long-term care regimes and proposes four case studies to illustrate the main barriers and drivers to deinstitutionalisation. Austria (Standard care mix) illustrates the importance of developing strong support systems for informal carers and strengthening home-based care provision. Sweden (UniversalNordic) has made great strides towards deinstitutionalisation by promoting coordination between care providers, but, the coverage and cost of services will soon become unsustainable unless appropriate support for family-based care is provided. Italy (Family-based) and the Czech Republic (Transition) represent situations where the rates of institutionalisation are relatively low and current policy is challenged to contain future growth. Both systems offer significant support to informal and family carers, but this historic over-reliance on household contributions to care is leading to a widening gap between supply and demand, which needs to be addressed through the strengthening of community-based services.The briefing concludes with a discussion of the core principles for reaching a sustainable balance between different long-term care settings. (Edited publisher abstract)