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What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands

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  • Alders, Peter
  • Costa-Font, Joan
  • de Klerk, Mirjam
  • Frank, Richard

Abstract

Though need factors would predict a higher rate of institutional use in Germany, in 2004 the percentage of people over 65 in institutions in the Netherlands was almost double the percentage in Germany. The lower nursing home utilization in Germany coincided with lower out-of-pocket costs, de facto means-testing of social assistance for such care, a lower perceived quality of nursing home, and less acceptance of the nursing home as a main care modality for adults experiencing functional impairments. These factors have developed over time and are consistent with a – relatively – large government responsibility toward care for the elderly and a preference for institutional care over home care in the Netherlands. The policy to encourage older adults to move to elderly homes to decrease the housing shortage after WWII might have had long-lasting effects. This paper points out that a key in the success of a reform is a behavioral change in the system. As there seems to be no single factor to decrease the percentage of older adults in nursing homes, a sequence of policies might be a more promising route.

Suggested Citation

  • Alders, Peter & Costa-Font, Joan & de Klerk, Mirjam & Frank, Richard, 2015. "What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands," Health Policy, Elsevier, vol. 119(6), pages 814-820.
    • Handle: RePEc:eee:hepoli:v:119:y:2015:i:6:p:814-820
    DOI: 10.1016/j.healthpol.2015.02.006
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    1. Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    2. Plaisier, Inger & Verbeek-Oudijk, Debbie & de Klerk, Mirjam, 2017. "Developments in home-care use. Policy and changing community-based care use by independent community-dwelling adults in the Netherlands," Health Policy, Elsevier, vol. 121(1), pages 82-89.
    3. Karmann, Alexander & Sugawara, Shinya, 2022. "Comparing the German and Japanese nursing home sectors: Implications of demographic and policy differences," CEPIE Working Papers 02/22, Technische Universität Dresden, Center of Public and International Economics (CEPIE).
    4. Pieter Bakx & Bram Wouterse & Eddy (E.K.A.) van Doorslaer & Albert Wong, 2018. "Better off at home? Effects of a nursing home admission on costs, hospitalizations and survival," Tinbergen Institute Discussion Papers 18-060/V, Tinbergen Institute.
    5. Heger, Dörte & Korfhage, Thorben, 2016. "Care choices in Europe: To each according to his needs?," Ruhr Economic Papers 649, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    6. Matus-López, Mauricio, 2015. "Long-term care policies in developing countries. Early efforts of home-based care in Chile," MPRA Paper 105476, University Library of Munich, Germany.
    7. Peter Alders & Hannie C. Comijs & Dorly J. H. Deeg, 2017. "Changes in admission to long-term care institutions in the Netherlands: comparing two cohorts over the period 1996–1999 and 2006–2009," European Journal of Ageing, Springer, vol. 14(2), pages 123-131, June.
    8. Schichel, Mignon C.P. & Veenstra, Marja Y. & Kempen, Gertrudis I.J.M. & de Vugt, Marjolein E. & van der Zanden, Brigitte A.M. & Verhey, Frans R.J., 2020. "Senior Friendly Communities: Designing an approach for cross-border exchange of public health policy," Health Policy, Elsevier, vol. 124(10), pages 1129-1136.
    9. van de Bovenkamp, Hester M. & Stoopendaal, Annemiek & Bochove, Marianne van & Bal, Roland, 2020. "Tackling the problem of regulatory pressure in Dutch elderly care: The need for recoupling to establish functional rules," Health Policy, Elsevier, vol. 124(3), pages 275-281.

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