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Pavlova Milena (Maastricht University, the Netherlands), Praznovszky Lena (Maastricht University, the Netherlands), Tambor Marzena (Jagiellonian University, Cracow, Poland), Golinowska Stanisława (Jagiellonian University, Cracow, Poland), Groot Wim (Maastricht University, the Netherlands)
Introduction. Challenges in Long-Term Care in Europe
Zdrowie Publiczne i Zarządzanie, 2019, t. 17, nr 3, s. 113-118, bibliogr. 53 poz.
Starzenie się społeczeństw, Proces starzenia się ludności, Opieka długoterminowa, Opieka nad osobami starszymi
Ageing of the population, Process of people ageing, Long-term care, Care for the elderly
European societies are ageing and the share of older persons is continuously increasing across the region. In 1950, only 12% of the European population was over 65 years old. At present, this share is already doubled and the estimations suggest that it will be over 36% in 2050. The ageing phenomenon is caused by the decreased fertility and increased life expectancy. While in the past, a woman in Europe had on average more than 2 children, since 2000, the fertility rate has fallen below that threshold. Next to that, European citizens live longer, 75 years on average at present compared to 66 years on average in the 1950's. Prolonged human life is a symbol of wealth and prosperity within the European societies but combined with the low fertility rate, it also creates challenges. Most importantly, the group of working people who can provide care to the older persons is shrinking while the group of older persons is becoming larger. Moreover, the increase of longevity is accompanied with a decreasing proportion of years spent independently. Women are particularly affected since most of their years in old age are spent in dependency. The imbalance between the demand and supply is expected to lead to shortages in care providers, a trend already experienced by countries with fast ageing population. The increased demand for care will require not only more care providers but also more financial resources. In 2014, the public spending on long-term care in the OECD countries was 1.4% of GDP but projections suggest that this share will substantially increase till 2050. There are however substantial differences across the European countries. The highest public spending on long-term care is observed in the Netherlands and Scandinavian countries (3-4% of GDP) and lowest in countries of Central and Eastern Europe, e.g. less than half percent in Poland, Hungary, Estonia and Latvia. This difference is not surprising given the difference in the long-term care systems in Europe and their historical development. While the Netherlands and Scandinavian countries have well developed systems of care for older persons, which offer a broad range of services, in Central and Eastern European countries, these systems are underdeveloped. The expansion and improvement of medical care provision in these countries during the communist period was not coupled with the same developments in long-term care (LTC). The care for elderly is still largely seen as the responsibility of the family. (fragment of text)
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