long-term care use and supply in europe: projections for germany ...

LONG-TERM CARE USE AND SUPPLY IN EUROPE | 13
Table 2.6 Predicted probabilities of institutionalisation in the Netherlands (in percent)
Pooled (males & females)
Age groups 1-2 limitations 3+ limitations
60-69 0.70 1.78
(10.43) (43.78)
70-74 1.35 3.22
(17.65) (58.90)
75-79 2.44 5.73
(28.09) (72.35)
80-84 7.97 11.30
(45.02) (84.55)
85+ 24.23 43.78
(83.34) (92.41)
Source: Calculation based on the estimates shown in Table 2.2
(availability of informal care =1, income=1500, number of disorders=0).
The estimated probability for people with dementia is shown in brackets.
Conclusion
Based on representative samples of elderly people, the estimated probability of institutionalisation
differs between Spain and the Netherlands. First, this probability is significantly lower for women than
for men in Spain, which is not the case in the Netherlands. It is not straightforward to link this
divergence with differences in LTC systems. On the contrary, the significant and negative impact of
comorbidities in Spain could be linked to differences in access to nursing homes among dependent
people with health troubles.
However, simulating predicted probabilities (Table 2.5 and Table 2.6) shows that age, number of
functional limitations and dementia increase the probability of institutionalisation in both countries. In
addition, the availability of informal care has a negative effect on institutionalisation in both countries.
Nevertheless, dementia appears to play a stronger role on institutionalisation in the Netherlands than in
Spain, a result that may reflect differences in access to nursing homes. Unfortunately, the correlation
between age and availability of informal care and the imprecision of age data for Spain make it difficult
to compare the simulated results.
Additionally, institutionalisation rates for Germany and for Poland cannot be compared with each other
or with estimates for Spain and the Netherlands because the administrative data used in Germany and
Poland are not representative of the population with functional limitations. Indeed, elderly people
suffering from incapacities and not enrolled in the long term care system are not, by definition,
registered in administrative data.
References
Böckerman, P., E. Johansson and S. Saarni (2010), Institutionalisation and quality of life for old age
individuals in Finland, ANCIEN (WP3), working paper.
Gaugler, J.E., S. Duval, K.A Anderson and R.L Kane (2007), “Predicting nursing home admission in the
US: a meta-analysis”, BMC Geriatrics, 7: 13.
Golinowska, S. and A. Sowa (2011), Supply and utilisation of residential LTC services in Poland,
CASE, ANCIEN background paper.