IDEAS home Printed from https://ideas.repec.org/a/spr/eujoag/v22y2025i1d10.1007_s10433-025-00840-6.html
   My bibliography  Save this article

Trajectories of long-term care entitlements in severely disabled older adults using nationwide Dutch data

Author

Listed:
  • France Portrait

    (Vrije Universiteit Amsterdam)

  • Yvonne Krabbe-Alkemade

    (Vrije Universiteit Amsterdam)

  • Trynke Hoekstra

    (Vrije Universiteit Amsterdam)

  • Kristina Thompson

    (Wageningen University & Research)

  • Hanna Rusticus

    (Vrije Universiteit Amsterdam)

Abstract

Long-term care trajectories typically vary in care types, transitions and durations. Understanding these patterns can help optimize care provision. This study aimed at (1) identifying formal long-term care trajectories of severely disabled older individuals, and (2) assessing the relationships between individual characteristics and these trajectories. Nationwide administrative data from the Centre for Care Needs Assessment were used. The sample included all 140,973 individuals older than 65 and with institutional care entitlements for somatic or psychogeriatric problems on July 1, 2015. The study period was from January 2010 to June 2019. Latent class growth analysis was performed to derive distinct care trajectories. Multinomial logistic regression analysis was used to examine the relationships between individual characteristics and these trajectories. Five trajectories were identified, varying in complexity and duration of needs in long-term care. Two were characterized by mostly mild (somatic) institutional care and three by (psychogeriatric) institutional care with increasing duration and intensity. Men and younger individuals were more likely to require intensive (psychogeriatric) institutional care. This study highlighted clear divergences among formal long-term care trajectories of severely disabled older individuals. Though less generous entitlement criteria may result in relatively lower expenditures in formal (institutional) care, they also imply increased use of alternatives, such as informal and community care. These insights can be used to tailor the provision of long-term care services in the future, and inform policy related to the financial sustainability of long-term care systems.

Suggested Citation

  • France Portrait & Yvonne Krabbe-Alkemade & Trynke Hoekstra & Kristina Thompson & Hanna Rusticus, 2025. "Trajectories of long-term care entitlements in severely disabled older adults using nationwide Dutch data," European Journal of Ageing, Springer, vol. 22(1), pages 1-15, December.
    • Handle: RePEc:spr:eujoag:v:22:y:2025:i:1:d:10.1007_s10433-025-00840-6
    DOI: 10.1007/s10433-025-00840-6
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10433-025-00840-6
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s10433-025-00840-6?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
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    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. David Autor & David Figlio & Krzysztof Karbownik & Jeffrey Roth & Melanie Wasserman, 2023. "Males at the Tails: How Socioeconomic Status Shapes the Gender Gap," The Economic Journal, Royal Economic Society, vol. 133(656), pages 3136-3152.
    3. Yang, Chih-Chien, 2006. "Evaluating latent class analysis models in qualitative phenotype identification," Computational Statistics & Data Analysis, Elsevier, vol. 50(4), pages 1090-1104, February.
    4. 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.
    5. Margaret J Penning & Denise S Cloutier & Kim Nuernberger & Stuart W S MacDonald & Deanne Taylor, 2018. "Long-term Care Trajectories in Canadian Context: Patterns and Predictors of Publicly Funded Care," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 73(6), pages 1077-1087.
    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. Shelley H. Liu & Yitong Chen & Jordan R. Kuiper & Emily Ho & Jessie P. Buckley & Leah Feuerstahler, 2024. "Applying Latent Variable Models to Estimate Cumulative Exposure Burden to Chemical Mixtures and Identify Latent Exposure Subgroups: A Critical Review and Future Directions," Statistics in Biosciences, Springer;International Chinese Statistical Association, vol. 16(2), pages 482-502, July.
    3. Zwiers, Merle & van Ham, Maarten & Manley, David, 2016. "Trajectories of Neighborhood Change: Spatial Patterns of Increasing Ethnic Diversity," IZA Discussion Papers 10216, Institute of Labor Economics (IZA).
    4. Yuan Liu & Hongyun Liu, 2019. "Effects of Distance and Shape on the Estimation of the Piecewise Growth Mixture Model," Journal of Classification, Springer;The Classification Society, vol. 36(3), pages 659-677, October.
    5. Sun-Joo Cho & Allan Cohen & Brian Bottge, 2013. "Detecting Intervention Effects Using a Multilevel Latent Transition Analysis with a Mixture IRT Model," Psychometrika, Springer;The Psychometric Society, vol. 78(3), pages 576-600, July.
    6. Li, Yumei & Duan, Wenjie & Chen, Zheng, 2020. "Latent profiles of the comorbidity of the symptoms for posttraumatic stress disorder and generalized anxiety disorder among children and adolescents who are susceptible to COVID-19," Children and Youth Services Review, Elsevier, vol. 116(C).
    7. Cato Waeterloos & Peter Conradie & Michel Walrave & Koen Ponnet, 2021. "Digital Issue Movements: Political Repertoires and Drivers of Participation among Belgian Youth in the Context of ‘School Strike for Climate’," Sustainability, MDPI, vol. 13(17), pages 1-19, September.
    8. Battisti, Michele & Kinne, Lavinia & Fedorets, Alexandra, 2022. "Cognitive Skills among Adults: An Impeding Factor for Gender Convergence?," VfS Annual Conference 2022 (Basel): Big Data in Economics 264110, Verein für Socialpolitik / German Economic Association.
    9. Portrait, France & Krabbe-Alkemade, Yvonne & Budding, Tjerk & Canoy, Marcel, 2023. "Passing on the hot potato. Dutch municipalities under financial pressure have incentives to shift the costs of social care for older people to the central government," Health Policy, Elsevier, vol. 137(C).
    10. Paterson, Molly & Parasnis, Jaai & Rendall, Michelle, 2024. "Gender, socioeconomic status, and numeracy test scores," Journal of Economic Behavior & Organization, Elsevier, vol. 227(C).
    11. Deslauriers-Varin, Nadine & Beauregard, Eric, 2014. "Consistency in crime site selection: An investigation of crime sites used by serial sex offenders across crime series," Journal of Criminal Justice, Elsevier, vol. 42(2), pages 123-133.
    12. Hu, Ran & Xue, Jia & Han, Ziqiang, 2021. "School bullying victimization and perpetration among Chinese adolescents: A latent class approach," Children and Youth Services Review, Elsevier, vol. 120(C).
    13. Grant Morgan & Mark D’Amico & Kari Hodge, 2015. "Major differences: modeling profiles of community college persisters in career clusters," Quality & Quantity: International Journal of Methodology, Springer, vol. 49(1), pages 1-20, January.
    14. Pengfei Wang & Xiang Wei & Xu Yingwei & Cao Xiaodan, 2022. "The Impact of Residents' Leisure Time Allocation Mode on Individual Subjective Well-being: The Case of China," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 17(3), pages 1831-1866, June.
    15. Frauke Kreuter & Ting Yan & Roger Tourangeau, 2008. "Good item or bad—can latent class analysis tell?: the utility of latent class analysis for the evaluation of survey questions," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 171(3), pages 723-738, June.
    16. Qi Chen & Wen Luo & Gregory J. Palardy & Ryan Glaman & Amber McEnturff, 2017. "The Efficacy of Common Fit Indices for Enumerating Classes in Growth Mixture Models When Nested Data Structure Is Ignored," SAGE Open, , vol. 7(1), pages 21582440177, March.
    17. Henri Lahti & Nelli Lyyra & Lauri Hietajärvi & Jari Villberg & Leena Paakkari, 2021. "Profiles of Internet Use and Health in Adolescence: A Person-Oriented Approach," IJERPH, MDPI, vol. 18(13), pages 1-15, June.
    18. Huber, Stefanie J. & Paule-Paludkiewicz, Hannah, 2024. "Gender norms and the gender gap in higher education," Labour Economics, Elsevier, vol. 87(C).
    19. Boncinelli, Fabio & Contino, Caterina & Romano, Caterina & Scozzafava, Gabriele & Casini, Leonardo, 2016. "Territory, environment, and healthiness in traditional food choices: insights into consumer heterogeneity," International Food and Agribusiness Management Review, International Food and Agribusiness Management Association, vol. 20(01), October.
    20. Devereux, Paul J. & Delaney, Judith, 2021. "Gender and Educational Achievement: Stylized Facts and Causal Evidence," CEPR Discussion Papers 15753, C.E.P.R. Discussion Papers.

    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:spr:eujoag:v:22:y:2025:i:1:d:10.1007_s10433-025-00840-6. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.