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Long-term care quality assurance policies in European countries
- Authors:
- DANDI Roberto, et al
- Publisher:
- European Network of Economic Policy Research Institutes
- Publication year:
- 2012
- Pagination:
- 89p.
- Place of publication:
- Brussels
This report present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 5 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe. This report analyses the quality assurance policies for long-term care (LTC) in the following countries: Austria, Estonia, Finland, France, Germany, Hungary, Italy, Latvia, Poland, Slovakia, Slovenia, Spain, Sweden, the Netherlands, and the United Kingdom. First, it discusses quality assurance in LTC by analysing: the dimensions of quality, the policy frameworks for quality in LTC, the different levels of development of LTC quality policies at the international, national, organisational, and individual levels. Second, it describes the methodology for collecting and analysing data on quality policies in the selected countries. Finally, it discusses the results, identifying four clusters of countries based on quality policies and indicators for LTC. These clusters are compared to the clusters identified in Work Package 1 of the ANCIEN project. Policy recommendations are proposed.
Quality assurance indicators of long-term care in European countries
- Authors:
- DANDI Roberto, CASANOVA Georgia
- Publisher:
- European Network of Economic Policy Research Institutes
- Publication year:
- 2012
- Pagination:
- 128p.
- Place of publication:
- Brussels
This report present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 5 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe. The report presents the quality indicators that were collected by the ANCIEN project partners in each country. The main contribution of this report is a classification of the quality assurance indicators in different European countries according to three dimensions: organisation type; quality dimensions; and system dimensions. The countries that provided quality indicators, which are used at a national level or are recommended to be used at a local level by a national authority, are: Estonia, Finland, France, Germany, Hungary, Italy, Latvia, the Netherlands, Spain, Sweden and the United Kingdom. In total, 390 quality indicators were collected. Each quality indicator has been assigned to one or more options in each dimension.
The Italian experience in protecting older people during COVID-19: lessons learned for long-term care facilities (LTCF)
- Authors:
- BUZELLI Maria Luisa, BOYCE Tammy
- Journal article citation:
- Journal of Long-Term Care, March 2022, pp.61-70. Online only
- Publisher:
- King's College London
- Place of publication:
- London
Context: Older people living in LTCF were particularly affected by COVID-19. Italy was the first country in Europe to experience high death rates among older people. Analysing the factors which may have determined high mortality rates in LTCF and identifying actions to safeguard older people's health in long-term care settings may be critical for future public health emergencies. Objectives: Identify the main challenges and failures faced by a small number of Italian professionals working in LTCF and suggest key actions to better protect older people's health in future emergencies. Methods: Rapid survey conducted among Italian professionals working in the LTC sector in Italy during the pandemic. Findings: Several factors contributed to higher death rates in LTCF for older people in Italy. To better protect LTCF residents in case of future health emergencies, actions need to be implemented in relation to LTCF’s management, governance and capacity building. Furthermore, safety plans and strategies need to be put in place to ensure older residents' protection and maintain high level of care in LTCF during public health emergencies, such as COVID-19. Limitations: The article reflects the opinions of a limited number of professionals working in the long-term care sector, which may not be representative of all workers operating in the sector. Implications: Policy and system changes are needed to strengthen the capacity of the Italian long- term care sector to respond to the needs of a growing older population in the context of COVID-19 and beyond. (Edited publisher abstract)
Supportive care for older people with dementia: socio-organisational implications
- Authors:
- MIELE Francesco, et al
- Journal article citation:
- Ageing and Society, 42(2), 2022, pp.376-408.
- Publisher:
- Cambridge University Press
For many years, dementia care has been dominated by the standard medical approach, in which dementia is treated mainly with drugs, such as anti-anxiety, antidepressant and anti-psychotic medications. With the aim of seeking effective treatments for patients with dementia, over the last years, several contributions have criticised the pervasive use of drugs for the management of behavioural and physiological symptoms related to dementia, proposing personalised interventions aimed at supporting patients and their relatives from diagnosis until death. With particular reference to long-term settings, this work is aimed at understanding the organisational implications of three types of interventions (labelled supportive care interventions - SCIs) that have characterised this shift in dementia care: person-centred, palliative and multi-disciplinary care. Conducted by following the integrative review method, this review underlines how SCIs have controversial consequences on the quality of care, the care-givers’ quality of life and cultural backgrounds. After an in-depth analysis of selected papers, this paper offers some considerations about the implications of SCIs for long-term care organisations and future research directions. (Edited publisher abstract)
Changing long-term care provision at the local level in times of austerity: a qualitative study
- Author:
- GORI Cristiano
- Journal article citation:
- Ageing and Society, 39(9), 2019, pp.2059-2084.
- Publisher:
- Cambridge University Press
This article explores the effects produced by cost-containment policies and austerity measures, which widened the gap between care needs and available public funding, on the provision of long-term care (LTC) services at the local level in Italy during the economic crisis. The study is based on 34 semi-structured interviews with services managers employed in Italy's publicly funded LTC system. Data were analysed with the framework analysis method and six cross-cutting thematic categories were identified that depict, according to the interviewees, the main transformations that occurred in the provision of LTC at the local level as a consequence of cost-containment policies. ‘Uncertainty’ refers to the inability to predict what direction the LTC system is going to take in the foreseeable future. ‘Short-termism’ illustrates the pressure to focus excessively on day-to-day service delivery at the expense of a medium- to long-term view of their future. ‘Endangering quality’ describes the risk of not being able to maintain the level of quality of care achieved so far. ‘Allocative tensions’ refers to the tensions due to the increasing requirement to ration the provision of public LTC services. ‘Unequal re-familiarisation’ represents the very different impacts of the trend of re-familiarisation depending on families’ financial situation. ‘Inappropriate care’ depicts the rising number of older people receiving public care interventions that are not appropriate to meet their needs. (Edited publisher abstract)
An international comparison of long-term care funding and outcomes: insights for the social care green paper
- Author:
- INCISIVE HEALTH
- Publisher:
- Incisive Health
- Publication year:
- 2018
- Pagination:
- 49
- Place of publication:
- London
This report, commissioned by Age UK, highlights different approaches to long-term care taken by five countries in the developed world, and looks at how they compare to the system in England. These five countries have very different systems, but face similar demographic and financial challenges to those in England. The countries are France, Germany, Spain, Italy and Japan. The report compares the approaches in relation to: service structures, funding levels, funding models, and outcomes. The findings suggest that creating a sustainable social care system fit for a rapidly ageing population is a challenge in every one of these countries. However, it finds that the financial deal for citizens with care needs is often more generous in other countries in comparison to England, with other nations generally either providing some non-means tested basic level of support, and/or cap the amount of co-payment to be made, and/or use a more gradual means-test. Profiles for each of the five countries are also included. (Edited publisher abstract)
Analysing equity in the use of long-term care in Europe
- Authors:
- RODRIGUES Ricardo, ILINCA Stefania, SCHMIDT Andrea
- Publisher:
- European Commission
- Publication year:
- 2014
- Pagination:
- 39
- Place of publication:
- Brussels
There are significant differences across social protection systems in Europe in the scope, breadth and depth of coverage of the risk to need long-term care in old-age. Together with other factors, such as education, household structure or societal values regarding care for frail older people, these differences can have a significant impact on the use of long-term care. Using SHARE data, this Research Note compares differences between European countries in the use of long-term care across income groups, for older people living at home. It analyses not only inequalities in the use of long-term care, but also differences in use that persist after differences in need have been taken into consideration, i.e. horizontal inequity. For this purpose, concentration indices, concentration curves and horizontal inequity indices are estimated for home care services and informal care. The countries analysed here are Austria, Germany, Sweden, the Netherlands, Spain, Italy, France, Denmark, Greece, Belgium and Czech Republic. The findings suggest that differences in use of home care services across income groups mostly reflect differences in need between those same groups. For informal care, the differences in use persist even after accounting for needs, and less affluent individuals are much more likely to use informal care. Some possible causes for these differences and policy implications are considered.
Trends in severe disability among elderly people: assessing the evidence in 12 OECD countries and the future implications
- Authors:
- LAFORTUNE Gaetan, et al
- Publisher:
- Organisation for Economic Co-operation and Development
- Publication year:
- 2007
- Pagination:
- 78p., bibliog.
- Place of publication:
- Paris
As the population aged 65 and over will continue to grow steadily in OECD countries over the next decades, improvements in the functional status of elderly people could help mitigate the rise in the demand for, and hence expenditure on, long-term care. This paper assesses the most recent evidence on trends in disability among the population aged 65 and over in 12 OECD countries: Australia, Belgium, Canada, Denmark, Finland, France, Italy, Japan, the Netherlands, Sweden, the United Kingdom and the United States. One of the principal findings from this review is that there is clear evidence of a decline in disability among elderly people in only five of the twelve countries studied (Denmark, Finland, Italy, the Netherlands and the United States). Three countries (Belgium, Japan and Sweden) report an increasing rate of severe disability among people aged 65 and over during the past five to ten years, and two countries (Australia, Canada) report a stable rate. In France and the United Kingdom, data from different surveys show different trends in ADL disability rates among elderly people, making it impossible to reach any definitive conclusion on the direction of the trend. One of the main policy implications that can be drawn from the findings of this study is that it would not be prudent for policymakers to count on future reductions in the prevalence of severe disability among elderly people to offset completely the rising demand for long-term care that will result from population ageing.
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.
Solidarity in Italy's policies towards the frail elderly: a value at stake
- Author:
- GORI C.
- Journal article citation:
- International Journal of Social Welfare, 9(4), October 2000, pp.261-269.
- Publisher:
- Wiley
The Italian public policies towards the frail elderly are undeveloped by both quantitative and qualitative standards. The bulk of care responsibilities lies on the family and the private provision of paid care is flourishing. In such a context several questions on solidarity arise regarding the degree to which this value is actually embedded in the public policies, what are the most relevant issues and how the main actors involved are concerned. The article aims to answer some of these questions, taking into consideration the points of view of the main actors; elderly people, carers and professionals.