Country Information and European Overviews

INTERLINKS has produced national and European overview papers with background information on key aspects of long-term care. You can read the European overview papers by clicking on the titles or on (more ...). You can access the national reports by choosing the relevant country from the left-hand menu.

Prevention and rehabilitation in long-term care

(...) As there exists a growing awareness of the increasing pressures on public finances embedded in a climate of uncertainty about economic developments expected for the EU, one important thread in public and political debates focuses on the potential of prevention and rehabilitation (P&R) for older people. While in the past many health and social care systems have focused on meeting the needs of those older people in crisis and immediate need of care, there is now a growing recognition of the need to intervene ‘upstream’ in order to keep older people healthier and living more independently for longer. This debate is simultaneously, but differently nurtured by, on the one hand, the focus on autonomy and quality of life of older people (humanitarian rationale) and on the other by the potential of the containment of public expenditure – linked to an onus on older people to keep themselves healthy – (economic rationale). However, whether and to what extent increased prevention efforts lead to reductions in costs remains contested as results are to be expected at long range and thus difficult to assess (more ...)

The role of informal care in long-term care

(...) LTC policies that aim to address the needs of informal carers are thus confronted with various contextual issues that remain difficult to disentangle. In order to get some clarification of the underpinning goals of policies and measures specifically directed toward supporting informal carers and their links with general LTC policies, we need a framework which classifies measures (both in-kind and in cash) into those that respond primarily to informal carers’ specific needs and to those primarily addressing the needs of older people; in both cases, measures can address these needs either directly or indirectly (more ...)

See also:

• Executive Summary
• Case study on 'Migrant care workers in Italy'

Quality assurance and quality management in long-term care

(...) In most EU member states long-term care (LTC) services for older people have originated in charities, voluntary organisations, social services for people with disabilities, ‘poor law’ regulations, i.e. in the context of local or regional social assistance legislation (Means/Smith, 1998; Leichsenring, 2004; Kerschen et al, 2005). In recent decades LTC has gradually developed into an acknowledged area of social security in-between social and health care – with increasing traits of a proper policy field and LTC services develop a quality of their own: Policies explicitly focusing on LTC have been developed to regulate access, quality and extent of benefits and services, public funding of LTC has increased, and in a growing number of countries even new benefit schemes were introduced (more ... including examples of good practice)

Governance and financing of long-term care

(...) In public welfare policies and in the context of ‘new public management’ approaches we have seen a general trend towards increasingly market-oriented governance mechanisms accompanied by decentralisation and the multiplication of actors (Nies et al., 2010; Kazepov, 2010) which, in most countries, implied the substitution of public providers by private service provision and/or at least a more strict purchaser-provider split within public authorities and the emergence of new types of providers (for-profit or non-profit) to complement public provision. In theory, the enhanced division of roles between public and private actors should enhance the problem solving capacity of the supply system and improve quality by means of competition between providers. However, this expectation has only shown scarce evidence over the past 20 years (more ...)