Alders Peter, Schut Frederik T
Erasmus School of Health Policy and Management,Erasmus University,Rotterdam,The Netherlands.
Health Econ Policy Law. 2019 Jan;14(1):82-100. doi: 10.1017/S1744133118000129. Epub 2018 May 21.
In several OECD countries the percentage of elderly in long-term care institutions has been declining as a result of ageing-in-place. However, due to the rapid ageing of population in the next decades future demand for institutional care is likely to increase. In this paper we perform a scenario analysis to examine the potential impact of these two opposite trends on the demand for institutional elderly care in the Netherlands. We find that the demand for institutional care first declines as a result of the expected increase in the number of low-need elderly that age-in-place. This effect is strong at first but then peters out. After this first period the effect of the demographic trend takes over, resulting in an increase in demand for institutional care. We argue that the observed trends are likely to result in a growing mismatch between demand and supply of institutional care. Whereas the current stock of institutional care is primarily focussed on low-need (residential) care, future demand will increasingly consist of high-need (nursing home) care for people with cognitive as well as somatic disabilities. We discuss several policy options to reduce the expected mismatch between supply and demand for institutional care.
在一些经合组织国家，由于就地养老，长期护理机构中老年人的比例一直在下降。然而，由于未来几十年人口的快速老龄化，机构护理的未来需求可能会增加。在本文中，我们进行了情景分析，以研究这两种相反趋势对荷兰机构养老护理需求的潜在影响。我们发现，由于预计就地养老的低需求老年人数量增加，机构护理需求首先下降。这种影响起初很强，但随后逐渐减弱。在这第一阶段之后，人口趋势的影响开始显现，导致机构护理需求增加。我们认为，观察到的趋势可能会导致机构护理的供需之间的不匹配日益加剧。当前的机构护理存量主要集中在低需求（住宿）护理上，而未来需求将越来越多地包括为患有认知和身体残疾的人提供的高需求（养老院）护理。我们讨论了几种政策选择，以减少机构护理供需之间预期的不匹配。
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