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

Sonila Tomini, Wim Groot & Milena Pavlova


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.

Keywords: Long-term care, population ageing, negative binomial regression model

JEL Codes: I18, H51, I11

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