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Ageing populations: spreading the costs
- Author:
- GILLION Colin
- Journal article citation:
- Journal of European Social Policy, 1(2), 1991, pp.107-128.
- Publisher:
- Sage
Over the next 50 years almost all the countries of the OECD are will experience a dramatic ageing of their population structures. This process will affect the burden, in terms of taxes or social security contributions, placed on active members of the population. If no changes occur in the (relative) level of benefits, the age of retirement, female participation rates, the level of unemployment, or the level of immigration: then the total burden of support by the active members of the population for the inactive and dependent will rise very considerably. This paper attempts to place broad magnitudes on the amount of the potential increase. The analysis goes on to ask: what if changes should occur in the underlying parameters such as benefits rates, retirement age, female participation, unemployment rates, immigration?
Trade-off between quality, price, and profit orientation in Germany’s nursing homes
- Authors:
- GERAEDTS Max, et al
- Journal article citation:
- Ageing International, 41(1), 2016, pp.89-98.
- Publisher:
- Springer
- Place of publication:
- New York
International data suggest that for-profit nursing homes tend to provide lower quality than not-for-profit nursing homes. In Germany, the relationships between profit orientation, price and quality of nursing homes have not been investigated. We performed an observational study using secondary data from statutory quality audits of all nursing homes in Germany. The relationships were analysed bivariately via Mann–Whitney U-Test and Kruskal-Wallis Test respectively, followed by a multivariate variance analysis which also covered the interaction effect between quality, price and type of ownership. 41 % of 10,168 German nursing homes were for-profit charging on average about 10 % less than not-for-profit homes. In five out of six quality categories under study, for-profit nursing homes provided lower quality than not-for-profit homes. Quality of care in all quality categories improved with increasing prices per day. However, for four out of six quality categories examined, the quality difference between for-profit and non-profit nursing homes existed independent of the price charged. When selecting a nursing home it is therefore advisable to consider the profit orientation of the institution. German legislation should require that statutory public quality reports contain details on the profit orientation of nursing homes. (Edited publisher abstract)
Future long-term care expenditure in Germany, Spain, Italy and the United Kingdom
- Authors:
- COMAS-HERRERA Adelina, et al
- Journal article citation:
- Ageing and Society, 26(2), March 2006, pp.285-302.
- Publisher:
- Cambridge University Press
This paper reports findings from a European Commission funded study of future long-term care expenditure in Germany, Italy, Spain and the United Kingdom, and presents projections of future long-term care expenditure in the four countries under a number of assumptions about the future. Macro-simulation (or cell-based) models were used to make comparable projections based on a set of common assumptions. A central base-case served as a point of comparison by which to explore the sensitivity of the models to alternative scenarios for the key determinants. The sensitivity of the models to variant assumptions about the future numbers of older people, the prevalence of functional dependency and informal care, patterns of long-term provision, and macroeconomic conditions are examined. It was found that, under the base-case, the proportion of gross domestic product spent on long-term care is projected to more than double between 2000 and 2050 in each country. The projected future demand for long-term care services for older people is sensitive to assumptions about the future number of older people, the prevalence of dependency and the availability of informal care, and projected expenditure is sensitive to assumptions about rises in the real unit-costs of services and the structure of the models. It is important, for planning purposes, to recognise the considerable uncertainty about future levels of long-term care expenditure.
European healthcare: care homes report 2014
- Author:
- KNIGHT FRANK
- Publisher:
- Knight Frank
- Publication year:
- 2014
- Pagination:
- 12
- Place of publication:
- London
This report explores the market composition, structure and context of continental Europe’s four largest care home markets: France, Germany, Spain and Italy. Demand for elderly care is expected to rise significantly, as decreasing fertility rates, coupled with increasing overall life expectancy, are driving up the share of elderly in the population. The growing number of elderly will impact on future demand for long-term care (LTC) services. However, while all types of LTC services are set to increase, they will not do so uniformly. Homecare, the preferred service line for most European countries in recent years, will prove to be inefficient given the rising share of patients with specialised medical needs. Additionally, societal changes, including declining family size, increasing childlessness and rising non-traditional living arrangements, mean that care homes will play a crucial role in caring for the increasing elderly population. The report shows that the somewhat restrictive domestic care home market has driven French-based operators towards further expansion abroad and a greater diversification of services. In Germany, while there remains an acute shortage of beds, the market has experienced an increased level of consolidation in recent years, as well as a string of acquisitions by foreign operators and private equity firms. The recent economic revitalisation has brought greater investor interest in Spain while the Italian care home market remains ripe for new development and investment. The relatively small size of the Italian industry, coupled with the considerable level of market fragmentation, means there is substantial room for new entrants and potentially greater consolidation of private and non-profit homes. (Edited publisher abstract)