Aging and Long Term Care Systems
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World Bank, Washington, DC
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Population aging is a global issue that
is either affecting or will soon affect virtually every
country around the world. With large numbers of older people
experiencing significant losses of intrinsic capacity,
leading a dignified and meaningful life is often only
possible with the care and support of others. Long-term care
(LTC) has therefore become one of the most rapidly
developing policy areas in OECD countries, where significant
institutional change and innovation have taken place over
the last two decades. Governance and finance arrangements
for the delivery of LTC differ between countries. LTC in the
Netherlands, Germany, Japan, The Republic of Korea, the
Scandinavian countries (Sweden, Denmark and Finland),
England, the United States, France1 were selected to cover
differences between systems. However, across the different
systems debates about intergenerational and state
responsibilities are increasing evident. The paper delivers
an up-to date assessment of design parameters and captures
the measures being taken to build financial sustainability
into LTC policy and program reforms. Rapid population aging
in low and middle income countries (LMICs) will inevitably
generate an increased demand for long-term care (LTC)
services. Research and practical experience from high income
countries – and the very diverse patterns of LTC in terms of
funding mechanism, the balance of formal and informal
services, the degree of state participation, and the overall
level of provision – hold important lessons.
Palabras clave
ELDERLY, OLD AGE, DEPENDENT, LONG-TERM HEALTHCARE, DEMOGRAPHICS, AGING, PUBLIC EXPENDITURE, SOCIAL ASSISTANCE, SOCIAL INSURANCE, SOCIAL PROTECTION, HEALTH INSURANCE