Unbiased Analysis of Today's Healthcare Issues

Long-Term Care in 5 European Countries

Written By: Jason Shafrin - Sep• 03•13

Trends in long-term care spending and use has been rising over time.  The graphs below, from Nadash et al. (2012) demonstrate this trend between 2000 and 2008.

Annual Expenditures Long-Term Care Expenditures

LTCexp

 

Annual Enrollment in Long-Term Care Programs

LTCenr
Today, I review the long-term care systems in five European countries: Austria, England, France, Germany, and the Netherlands.

Austria

  • Financing: 100% from general revenues
  • Eligibility: Most individuals are eligible.  Austrian cash allowance is available regardless of age or type of disabling condition, but until recently it has primarily benefited the elderly.
  • Cash Benefit
    • Cash Benefit Name: Pflegegeld
    • Average Cash Payment: 642 USD
    • Range of Cash Payments: $222-$2385
    • Cash Benefits Vary by: functional/health status
    • Caregiver Benefits: Money for dementia care, supplement for 24 hour care, pension credits

England

  • Financing: 100% from general revenues
  • Cash Benefits
    • Cash Benefit Name: Direct Payments
    • Average Cash Payment: N/A USD
    • Range of Cash Payments: $71-$1410
    • Cash Benefits Vary by: income (means-tested and charges apply) and functional/health status
    • Caregiver Benefits: Means-tested Carer’s Allowance, pension rights

France

  • Financing: a large majority of premiums from general revenues.  Copayments depend on income low-income elders pay no co-payments, while higher income individuals pay co-payments of up to 90 percent.
  • Eligibility: covers non-institutionalized individuals 60 and older.  Has a a separate (smaller and older) scheme for younger disabled adults.
  • Cash Benefits
    • Cash Benefit Name: Allocation Personnalisée d’Autonomie
    • Average Cash Payment: 711 USD
    • Range of Cash Payments: $39-$1780
    • Cash Benefits Vary by: income (copayments up to 90%) and functional/health status
    • Caregiver Benefits: Tax benefits, 3 months of unpaid leave

Germany

  • LTC insurance is mandatory
  • Financing: solely from individual contributions
  • Eligibility: weighted towards those with needs for “hands-on” physical assistance and/or protective oversight related to dementia. Favors age-related disabilities.
  • Cash Benefits
    • Name: Pflegegeld
    • Average Cash Payment: N/A
    • Range of Cash Payments: $324-$986
    • Cash Benefits Vary by: Functional/Health Status only
    • Caregiver Benefits: Up to $2,117 to cover respite for 4 week vaciation, 6 months of unpaid leave, Social Security Benefits

Netherlands

  • Financing: In “AWBZ” program, about a third of the financing comes from general revenues, two-third from individual contributions of 12.5% of income split between employer and employee (up to a maximum of $474).
  • Eligibility: Covers people of all ages with all types of disabilities and conditions (including psychiatric conditions) in a range of settings, from institutions to homes
  • Cash Benefits
    • Cash Benefit Name: Persoonsgebonden Budget
    • Average Cash Payment: 1741
    • Range of Cash Payments: $600-$6600
    • Cash Benefits Vary: Yes – by income (copayments) and functional/health status
    • Caregiver Benefits: $360 annual allowance, savings plan (1% of salary), 2 weeks of leave at 70% of wages, 12 weeks unpaid leave

Source:

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4 Comments

  1. Assisted Living Facilities Tampa FL

    Long Term Care is on the rise with the senior population. We are seeing a big need for our services in Tampa Florida. This is interesting to see the 5 other countries.

  2. […] The Healthcare Economist reports data about long-term care trends and investigates the systems in Austria, England, France, Germany and the Netherlands. For many disabled elderly individuals, a nursing home is their only option.  How do European countries take care of the long-term disabled? […]

  3. Great report! It offers the topic nicely included.

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