IDEAS home Printed from https://ideas.repec.org/a/eee/joecag/v32y2025ics2212828x25000519.html

Trend in length-of-stay in nursing homes: Evidence from the Netherlands

Author

Listed:
  • Alders, Peter
  • Wouterse, Bram
  • Schut, Frederik T.

Abstract

For an accurate prediction of the future demand of nursing home care, adequate insight in the trend in length-of-stay (LOS) in nursing homes is required. Almost no research has been done on the trend in LOS and its determinants. We used individual data on nursing home use for the entire Dutch population combined with information on age, gender, cohabitation, care needs, and date of death. Our final sample consisted of 433,377 individual nursing home admissions over the period 2012 through 2022 in the Netherlands. Although the average age at admission was relatively stable, the age distribution got more dispersed over time, because of a simultaneous increase in the share of relatively young older adults in the older population due to the post-war babyboom and the postponement of nursing home admissions to higher ages at the individual level. Furthermore, relatively more men and older adults with higher care needs were admitted to a nursing home. We performed a survival analysis to calculate the expected LOS. We decomposed the trend in LOS into three partial effects: a demographic effect, an effect due to changes in care needs, and a residual time trend. We found that over a period of 11 years, the LOS decreased with 8 %, from 930 days in 2012 to 853 days in 2022. This downward trend is explained by a combination of population ageing (27 %), an influx of older adults with higher care needs (40 %), and other factors captured by the time trend (32 %).

Suggested Citation

  • Alders, Peter & Wouterse, Bram & Schut, Frederik T., 2025. "Trend in length-of-stay in nursing homes: Evidence from the Netherlands," The Journal of the Economics of Ageing, Elsevier, vol. 32(C).
    • Handle: RePEc:eee:joecag:v:32:y:2025:i:c:s2212828x25000519
    DOI: 10.1016/j.jeoa.2025.100596
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S2212828X25000519
    Download Restriction: no
    File URL: https://libkey.io/10.1016/j.jeoa.2025.100596?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Bakx, Pieter & Douven, Rudy & Schut, Frederik T., 2021. "Does independent needs assessment limit use of publicly financed long-term care?," Health Policy, Elsevier, vol. 125(1), pages 41-46.
    2. Xu, Mengyi & Yan, Gaoyun, 2025. "Length of stay in residential aged care: Patterns and determinants from a population-based cohort study," Insurance: Mathematics and Economics, Elsevier, vol. 122(C), pages 214-229.
    3. Hans C. Van Houwelingen, 2007. "Dynamic Prediction by Landmarking in Event History Analysis," Scandinavian Journal of Statistics, Danish Society for Theoretical Statistics;Finnish Statistical Society;Norwegian Statistical Association;Swedish Statistical Association, vol. 34(1), pages 70-85, March.
    4. Alders, Peter & Schut, Frederik T., 2019. "Trends in ageing and ageing-in-place and the future market for institutional care: scenarios and policy implications," Health Economics, Policy and Law, Cambridge University Press, vol. 14(1), pages 82-100, January.
    5. Maarse, J.A.M. (Hans) & Jeurissen, P.P. (Patrick), 2016. "The policy and politics of the 2015 long-term care reform in the Netherlands," Health Policy, Elsevier, vol. 120(3), pages 241-245.
    6. 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.
    7. Shemendyuk, Aleksandr & Wagner, Joël, 2024. "On the factors determining the health profiles and care needs of institutionalized elders," Insurance: Mathematics and Economics, Elsevier, vol. 114(C), pages 223-241.
    8. Bladt, Martin & Fuino, Michel & Shemendyuk, Aleksandr & Wagner, Joël, 2023. "Modelling the burden of long-term care for institutionalised elderly based on care duration and intensity," Annals of Actuarial Science, Cambridge University Press, vol. 17(1), pages 83-117, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alders, Peter & Schut, Frederik T., 2022. "Strategic cost-shifting in long-term care. Evidence from the Netherlands," Health Policy, Elsevier, vol. 126(1), pages 43-48.
    2. Xu, Mengyi & Yan, Gaoyun, 2025. "Length of stay in residential aged care: Patterns and determinants from a population-based cohort study," Insurance: Mathematics and Economics, Elsevier, vol. 122(C), pages 214-229.
    3. Krabbe-Alkemade, Yvonne & Makai, Peter & Shestalova, Victoria & Voesenek, Tessa, 2020. "Containing or shifting? Health expenditure decomposition for the aging Dutch population after a major reform," Health Policy, Elsevier, vol. 124(3), pages 268-274.
    4. Marianne Tenand & Pieter Bakx & Bram Wouterse, 2021. "The impact of co-payments for nursing home care on use, health, and welfare," CPB Discussion Paper 430, CPB Netherlands Bureau for Economic Policy Analysis.
    5. Shemendyuk, Aleksandr & Wagner, Joël, 2025. "Evolution of institutional long-term care costs based on health factors," Insurance: Mathematics and Economics, Elsevier, vol. 120(C), pages 107-130.
    6. Alders, Peter & Schut, Frederik T., 2019. "The 2015 long-term care reform in the Netherlands: Getting the financial incentives right?," Health Policy, Elsevier, vol. 123(3), pages 312-316.
    7. Gustavo Soutinho & Luís Meira-Machado, 2023. "Nonparametric estimation of the distribution of gap times for recurrent events," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 32(1), pages 103-128, March.
    8. Yu Zheng & Tianxi Cai, 2017. "Augmented estimation for t‐year survival with censored regression models," Biometrics, The International Biometric Society, vol. 73(4), pages 1169-1178, December.
    9. Matus-López, Mauricio, 2021. "Diferencia entre cuidados a la dependencia y cuidados de larga duración o long-term care. Una aclaración necesaria [Difference between dependency care and long-term care. A necessary clarification]," MPRA Paper 107959, University Library of Munich, Germany.
    10. Joan Costa-Font & Valentina Zigante, 2020. "Building ‘implicit partnerships’? Financial long-term care entitlements in Europe," Policy Sciences, Springer;Society of Policy Sciences, vol. 53(4), pages 697-712, December.
    11. Rellstab, Sara & Bakx, Pieter & García-Gómez, Pilar & van Doorslaer, Eddy, 2020. "The kids are alright - labour market effects of unexpected parental hospitalisations in the Netherlands," Journal of Health Economics, Elsevier, vol. 69(C).
    12. Shemendyuk, Aleksandr & Wagner, Joël, 2024. "On the factors determining the health profiles and care needs of institutionalized elders," Insurance: Mathematics and Economics, Elsevier, vol. 114(C), pages 223-241.
    13. Bin Qiu & Wei Guo & Fan Zhang & Fang Lv & Ying Ji & Yue Peng & Xiaoxi Chen & Hua Bao & Yang Xu & Yang Shao & Fengwei Tan & Qi Xue & Shugeng Gao & Jie He, 2021. "Dynamic recurrence risk and adjuvant chemotherapy benefit prediction by ctDNA in resected NSCLC," Nature Communications, Nature, vol. 12(1), pages 1-11, December.
    14. Marie Blaise & Laetitia Dillenseger, 2023. "Informal Caregivers and Life Satisfaction: Empirical Evidence from the Netherlands," Journal of Happiness Studies, Springer, vol. 24(6), pages 1883-1930, August.
    15. Mikkers, Misja, 2016. "The Dutch Healthcare System in International Perspective," Other publications TiSEM 800704a0-24ee-4830-8659-2, Tilburg University, School of Economics and Management.
    16. Costa-Font, Joan & Zigante, Valentina, 2020. "Building ‘implicit partnerships’? Financial long-term care entitlements in Europe," LSE Research Online Documents on Economics 106099, London School of Economics and Political Science, LSE Library.
    17. Quitterie Roquebert & Remi Kabore & Jerome Wittwer, 2018. "Decentralized policies and formal care use by the disabled elderly," PSE Working Papers halshs-01877829, HAL.
    18. Noort, Bart A.C. & Ahaus, Kees & van der Vaart, Taco & Chambers, Naomi & Sheaff, Rod, 2020. "How healthcare systems shape a purchaser’s strategies and actions when managing chronic care," Health Policy, Elsevier, vol. 124(6), pages 628-638.
    19. Kulinskaya, Elena & Gitsels, Lisanne Andra & Bakbergenuly, Ilyas & Wright, Nigel R., 2021. "Dynamic hazards modelling for predictive longevity risk assessment," Insurance: Mathematics and Economics, Elsevier, vol. 96(C), pages 222-231.
    20. Bom, Judith & Stöckel, Jannis, 2021. "Is the grass greener on the other side? The health impact of providing informal care in the UK and the Netherlands," Social Science & Medicine, Elsevier, vol. 269(C).

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:joecag:v:32:y:2025:i:c:s2212828x25000519. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: https://www.journals.elsevier.com/the-journal-of-the-economics-of-ageing .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.