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The Long-Term Care Workforce: Overview and Strategies to Adapt Supply to a Growing Demand

Author

Listed:
  • Rie Fujisawa

    (OECD)

  • Francesca Colombo

    (OECD)

Abstract

This working paper offers an overview of the LTC workforce and reviews country responses to a growing demand for LTC workers. In the context of ageing societies, the importance of long-term care is growing in all OECD countries. In 2005, long-term care expenditure accounted for slightly over 1% of GDP across OECD countries (OECD Health Data 2008), but this is projected to reach between 2% and 4% of GDP by 2050 (Oliveira Martins et al., 2006). Spending on long-term care as a share of GDP rises with the share of the population that is over 80 years old, which is expected to triple from 4 per cent to 11-12 per cent between 2005 and 2050. In addition to ageing, there are other factors likely to affect future spending. Trends in severe disability among elderly populations across 12 OECD countries for which data are available do not show a consistent sign of decline (Lafortune and Balestat, 2007), while the number of elderly that need assistance in carrying out activities of daily living is also growing. Meanwhile, societal changes – notably possible reductions in the importance of informal care due to rising labour market participation by women and declining family size, as well as growing expectations for more responsive, quality health and social-care systems – are creating pressures to improve value for money in long-term care systems. These factors add pressures on the workforce of this highly labour-intensive sector. Adding to this are the difficulties in attracting and retaining caregivers to a physically and mentally gruelling profession. Soins de longue durée: l'accroissement de la demande de travailleurs du secteur Ce document de travail présente une vue d’ensemble sur les travailleurs du secteur des soins de longue durée (SLD) et passe en revue les réponses des pays à l'accroissement de la demande de travailleurs des SLD. Dans le contexte du vieillissement des sociétés, l’importance des soins de longue durée va se développer dans tous les pays de l’OCDE. En 2005, les dépenses de SLD ne représentaient guère plus de 1 % du PIB dans ces différents pays (Éco-Santé OCDE 2008), mais d’après les projections, cette proportion pourrait atteindre entre 2 et 4 % du PIB à l’horizon 2050 (Oliveira Martins et al., 2006). La part des dépenses de SLD exprimées en pourcentage du PIB augmente en même temps que s’accroît la part de la population âgée de plus de 80 ans. Or, cette part devrait tripler entre 2005 et 2050 et passer de 4 % à 11 ou 12 % sur cette période. Outre le vieillissement, d’autres facteurs pouvant affecter les dépenses futures sont impliqués. Dans 12 pays de l’OCDE pour lesquels on dispose de données, la tendance à l’incapacité sévère chez les personnes âgées ne diminue pas de manière régulière (Lafortune et Balestat, 2007), tandis que le nombre de personnes âgées ayant besoin d’aide pour accomplir les activités élémentaires de la vie quotidienne est en augmentation. En même temps, l’évolution de la société (notamment, la possible diminution d’importance qui devrait être accordée aux soins informels du fait de l’accroissement du taux d’activité des femmes et de la diminution de la taille des familles, mais aussi les attentes croissantes face à des systèmes de soins de santé et de protection sociale que l’on voudrait plus réactifs et de meilleure qualité) accroît la nécessité d’une utilisation plus efficiente des ressources des systèmes de SLD. Ces facteurs renforcent la pression qui s’exerce sur les travailleurs de ce secteur à très forte intensité de main-d’oeuvre. S’y ajoutent les difficultés rencontrées pour attirer des soignants vers un métier pénible à la fois physiquement et psychologiquement et pour les retenir.

Suggested Citation

  • Rie Fujisawa & Francesca Colombo, 2009. "The Long-Term Care Workforce: Overview and Strategies to Adapt Supply to a Growing Demand," OECD Health Working Papers 44, OECD Publishing.
  • Handle: RePEc:oec:elsaad:44-en
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    File URL: http://dx.doi.org/10.1787/225350638472
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    Cited by:

    1. Gianluca Misuraca & Giulio Pasi & Maria Cesira Urzi Brancati, 2017. "The potential and impact of ICT-enabled Social Innovation to promote social investment in the EU," JRC Working Papers JRC108517, Joint Research Centre (Seville site).
    2. Flavia Coda Moscarola, 2010. "Informal Caregiving and Women's Work Choices: Lessons from the Netherlands," LABOUR, CEIS, vol. 24(1), pages 93-105, March.
    3. Stephanie Carretero & James Stewart & Clara Centeno & Francesco Barbabella & Andrea Schmidt & Frederique Lamontagne-Godwin & Giovanni Lamura, 2012. "Can technology – based services support long-term care challenges in home care? Analysis of evidence from social innovation good practices across the EU CARICT Project Summary Report," JRC Working Papers JRC77709, Joint Research Centre (Seville site).
    4. Geyer, Johannes & Haan, Peter & Korfhage, Thorben, 2015. "Indirect fiscal effects of long-term care insurance," Ruhr Economic Papers 584, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    5. Momota, Akira, 2012. "Population aging and sectoral employment shares," Economics Letters, Elsevier, vol. 115(3), pages 527-530.
    6. Nguyen, Ha Trong & Connelly, Luke Brian, 2014. "The effect of unpaid caregiving intensity on labour force participation: Results from a multinomial endogenous treatment model," Social Science & Medicine, Elsevier, vol. 100(C), pages 115-122.
    7. Juan Oliva-Moreno & Marta Trapero-Bertran & Luz Maria Peña-Longobardo & Raúl del Pozo-Rubio, 2017. "The Valuation of Informal Care in Cost-of-Illness Studies: A Systematic Review," PharmacoEconomics, Springer, vol. 35(3), pages 331-345, March.
    8. Schulz, Erika & Geyer, Johannes, 2013. "Societal Change, Care Need and Long-Term Care Workforce in Selected European Countries," EconStor Preprints 128602, ZBW - German National Library of Economics.
    9. Gianluca Misuraca & Csaba Kucsera & Fiorenza Lipparini & Christian Voigt & Raluca Radescu, 2016. "Mapping and Analysis of ICT-enabled Social Innovation initiatives promoting social investment in integrated approaches to the provision of social services: IESI Knowledge Map 2015," JRC Working Papers JRC101042, Joint Research Centre (Seville site).
    10. Courtin, Emilie & Jemiai, Nadia & Mossialos, Elias, 2014. "Mapping support policies for informal carers across the European Union," Health Policy, Elsevier, vol. 118(1), pages 84-94.
    11. Schulz, Erika, 2014. "Impact of Ageing on Long-Term Care Workforce in Denmark," EconStor Preprints 128603, ZBW - German National Library of Economics.
    12. Adriaan Kalwij & Giacomo Pasini & Mingqin Wu, 2014. "Home care for the elderly: the role of relatives, friends and neighbors," Review of Economics of the Household, Springer, vol. 12(2), pages 379-404, June.
    13. Christine de la Maisonneuve & Joaquim Oliveira Martins, 2013. "Public Spending on Health and Long-term Care: A new set of projections," OECD Economic Policy Papers 6, OECD Publishing.
    14. Visintin, Stefano & Elvira, Marta & Rodríguez-Lluesma, Carlos, 2013. "Job (in)stability in the European Long-Term Care Workforce," IESE Research Papers D/1078, IESE Business School.
    15. Karin Eeden & Dennis Moeke & René Bekker, 2016. "Care on demand in nursing homes: a queueing theoretic approach," Health Care Management Science, Springer, vol. 19(3), pages 227-240, September.
    16. Tennyson, Sharon & Yang, Hae Kyung, 2014. "The role of life experience in long-term care insurance decisions," Journal of Economic Psychology, Elsevier, vol. 42(C), pages 175-188.
    17. Kroezen, Marieke & Dussault, Gilles & Craveiro, Isabel & Dieleman, Marjolein & Jansen, Christel & Buchan, James & Barriball, Louise & Rafferty, Anne Marie & Bremner, Jeni & Sermeus, Walter, 2015. "Recruitment and retention of health professionals across Europe: A literature review and multiple case study research," Health Policy, Elsevier, vol. 119(12), pages 1517-1528.
    18. Schulz, Erika, 2013. "Ageing, Care Need and Long-Term Care Workforce in Germany," EconStor Preprints 128597, ZBW - German National Library of Economics.
    19. Angermann, Annette & Eichhorst, Werner, 2012. "Report No. 45: Unterstützende Dienstleistungen für ältere Menschen im europäischen Vergleich," IZA Research Reports 45, Institute for the Study of Labor (IZA).

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J1 - Labor and Demographic Economics - - Demographic Economics
    • J10 - Labor and Demographic Economics - - Demographic Economics - - - General
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • J20 - Labor and Demographic Economics - - Demand and Supply of Labor - - - General
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

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