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

LONG-TERM CARE USE AND SUPPLY IN EUROPE | 33
2010; Kadushin, 2004b), is household composition. In the next step, projected numbers of older persons
by age category, gender and disability level are further divided according to household composition (h)
into persons living alone and persons living with others (N a,g,d,h,t ). For each age x gender x disability
group, the shares of persons living alone and with others in the base year t0, Ph a,g,d,t0 , have been derived
from national survey or SHARE data. The shares have been adjusted to match base year official national
statistics of the population by household composition, if available. Age and gender specific adjustment
factors Adj a,g have been calculated as follows:
Adj , Ph ,
Ph ′ ,
(1)
with Ph a,g being base year proportions of persons living alone or with others by age and gender as
derived from survey data and Ph’ a,g being the ‘official’ base year proportions. These adjustment factors
are applied to Ph a,g,d,t0 , so as to obtain adjusted proportions:
Ph ,,, Ph ,,,
Adj ,
(2)
In the base scenario, it is assumed that the base year household composition distribution by age, gender
and disability will remain constant over the projection horizon. The sensitivity to this assumption is
explored in an alternative scenario. The projected numbers of persons aged 65 and over by age category,
gender, disability level and household composition are thus calculated as follows:
N ,,,, N ,,, Ph ,,,
(3)
c. Education
The older population by age, gender, disability and household composition is further split by
educational level. In several countries, education has been identified as a significant determinant of LTC
use, although the effects are generally not very strong (Van den Bosch et al., 2011; Gaugler et al., 2007;
Geerts, 2010). For each age x gender x disability x household composition group, the distribution by
educational level in the base year Pe a,g,d,h,t0 has been derived from national survey data or SHARE data.
Three educational levels are distinguished, using the International Standard Classification of Education
(ISCED 97): low (no or primary education; ISCED 0-1), medium (secondary education; ISCED 2-4)
and high (tertiary education; ISCED 5-6).
The base scenario assumes constant proportions of low, medium and high-educated older persons by
age, gender, disability and household composition. The projected numbers of persons aged 65 and over
by age category, gender, disability level, household composition and educational level are calculated as
follows:
N ,,,,, N ,,,, Pe ,,,,
(4)
d. Other characteristics
Finally, projected numbers of older persons by age, gender, disability, household composition and
education, have been further split by characteristics that have been identified in Chapters 2 and 3 as
significant drivers of residential or home care utilisation. Variables included in the models are: number
of limitations with instrumental activities of daily living (IADLs), suffering from dementia or having