Vulnerability and Long-term Care in Europe

Abstract

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Demand of long‐term care and benefit eligibility across European countries

“…Access to formal home care is largely not discretionary for older adults in Europe: Regulations of most public programmes define eligibility by comparing an applicant's “vulnerability profile” with some “requirements for objective vulnerability” (Brugiavini, Carrino, Orso, & Pasini, ). Objective vulnerability often consists in a nonlinear aggregation of information on functional (e.g., ADL and iADL tasks) and cognitive limitations, yet such algorithms are highly heterogeneous within and between countries, in terms of what outcomes are included in the vulnerability profile and of weights assigned to each outcome.…”

“…Second, four questions on mental orientation and coherence ask respondents to report the current date, month, year, and day of week; following Castro‐Costa et al (), we label as impaired (orientation impairment) those respondents who gave zero or one correct answers. This information allow us to build individual clinical profiles comparable with the LTC regulations of the selected countries (see Brugiavini et al, ).…”

Demand of Long-Term Care and Benefit Eligibility Across European Countries

“…Second, four questions on mental orientation and coherence ask respondents to report the current date, month, year, and day of week; following Castro-Costa et al (2007), we label as impaired (orientation impairment) those respondents who gave zero or one correct answers. This information allow us to build individual clinical profiles comparable with the LTC regulations of the selected countries (see Brugiavini et al, 2017).…”

“…It is a valid instrument if it is informative and exogenous. Informativeness lies on the high heterogeneity in the algorithm and weights embedded in each programme's eligibility rules (Brugiavini et al, 2017). An illustration on why this is the case is provided in Table 4.…”

Cash‐for‐care payments in Europe: Changes in resource allocation

“…As an example, in England, the attendance allowance is defined as welfare spending and not included in the LTC spending (Robertson, Gregory, & Jabbal, ). Microdata collected through surveys are often used in cross‐country analysis (see, e.g., empirical examples using the Survey of Health, Ageing, and Retirement in Europe, such as Brugiavini, Carrino, Orso, & Pasini, ) but are not suitable for our analysis for two reasons. First, there are no comparable survey data that could fully cover the long‐time horizon taken nor accounting for the specificity of the CfCs included in this analysis.…”