Long term care system in comparative perspective: Private care resources and family involvement in care
Matteo Luppi | Collegio Carlo Alberto
This work examines the relation between the characteristics of the national Long Term Care (LTC) sectors and the families’ involvement in care for older people. A growing literature has employed the notion of defamilization and incorporated the gender dimension into the comparative examination of care model. In relation to the elderly care sector, whereas the gender perspective of caring responsibility has been broaden analysed, and represent an important field of research, the economic involvement of families in the care process and the related economic inequalities have been pursued to a lesser extent. This study tries to fill the gap by analysing the extent of familialism of the European LTC systems, considering conjointly both the degree of families’ involvement in the care process - in terms of time and private financing - and the macro dimensions that determine or affect this degree of involvement. Based on the recent reform processes that have interested the European LTC sectors, we have identified four macro dimensions of LTC systems that may affect the private involvement in the care of older people.
The first result of this article, obtained through a cluster analysis, is a division of the European countries considered on the basis of the characteristics of their LTC systems that affect the level of private resources (time and money) that dependent older people and their family members devote to care. The analysis of the grouping of countries through the lens of the families involvement in care process shows the importance played by the identified dimensions in the understanding the balancing of care responsibilities between public and private sphere. The analysis also highlights the absence of a trade-off between the economic and non-economic family care burden: the more time to care is needed, the more out-of-pocket expenditures are required. The study concerns fourteen EU countries selected according to data availability, whereas the main sources of data are represented by two international sources - System of Health account (SHA) and ESSPROS.