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The determinants of home based long-term care utilisation in Western European countries


  • Tomini, Sonila

    () (UNU-MERIT/MGSoG)

  • Groot, Wim

    (CAPHRI and TIER, Maastricht University)

  • Pavlova, Milena

    (CAPHRI, Maastricht University)


The need for long-term care (LTC) is projected to increase in all European countries due to the ageing of the population. The number of people aged 65 and older will double in EU-15 countries by 2050 under a pure ageing scenario and will increase by more than 30 per cent under the constant disability scenario. The aim of this paper is to see how different individual characteristics and the LTC systems around Western Europe influence the utilisation of formal LTC (in terms of frequency of services received). The data used from this study come from the Survey of Health Ageing and Retirement in Europe (SHARE) 2004-2005. We test here the individuals and systems characteristics determining the influence of use professional home-based LTC service (nursing care, domestic home assistance and meals-on-wheals). The frequencies are modelled using a negative binomial regression model. Our findings indicate that utilisation of professional home-based LTC increases significantly with factors like age, education, income and ADL (Activities of Daily Living) score. We found that the utilisation of LTC services is closely linked to the policy priorities, the financing and the organisations of the LTC system. In countries like the Netherlands, where a greater policy emphasis is put on home-based care, the utilisation of home-based LTC is higher compared with most of the other countries in the study.

Suggested Citation

  • Tomini, Sonila & Groot, Wim & Pavlova, Milena, 2012. "The determinants of home based long-term care utilisation in Western European countries," MERIT Working Papers 069, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
  • Handle: RePEc:unm:unumer:2012069

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    References listed on IDEAS

    1. K. Bolin & B. Lindgren & P. Lundborg, 2008. "Informal and formal care among single-living elderly in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 393-409.
    2. Bonsang, Eric, 2009. "Does informal care from children to their elderly parents substitute for formal care in Europe?," Journal of Health Economics, Elsevier, vol. 28(1), pages 143-154, January.
    3. de Meijer, Claudine & Koopmanschap, Marc & d' Uva, Teresa Bago & van Doorslaer, Eddy, 2011. "Determinants of long-term care spending: Age, time to death or disability?," Journal of Health Economics, Elsevier, vol. 30(2), pages 425-438, March.
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    More about this item


    Long-term care; population ageing; negative binomial regression model;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets


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