Tinios Platon, Valvis Zafiris
Associate Professor, Department of Statistics & Insurance Science, University of Piraeus, Piraeus, Greece.
PhD Candidate, Department of Statistics & Insurance Science, University of Piraeus, Piraeus, Greece.
J Aging Soc Policy. 2023 Nov 2;35(6):723-742. doi: 10.1080/08959420.2022.2110810. Epub 2022 Aug 11.
International comparisons of long-term care (LTC) are hampered by inconsistencies in how to define the need for care. This is especially relevant for the European Union, whose Aging Working Group, which is tasked to project aging expenditure in the long term, has over time used two competing definitions - one based on inability to perform Activities of Daily Living (ADL) and another based on the more subjective Global Activity Limitation Index (GALI). The inconsistency in measurement, as well as problems in defining the intensity of needs, will acquire growing significance as longevity progresses. This paper investigates how the two measures are linked, by analyzing a large European sample survey where respondents replied to both questions. This allows a calibration of the two measures and an investigation of their areas of overlap and difference. The paper concludes by proposing a simple new 4-scale measure of care needs which, by combining the two metrics, introduces some gradation of the intensity of care. Using a consistent measure incorporating intensity, such as the one proposed, will facilitate international comparisons, improve long-term expenditure projections, and aid policy discussion, including the transfer of best practice.
长期护理（LTC）的国际比较因护理需求定义的不一致而受阻。这对欧盟尤为重要，其老龄化问题工作组负责长期预测老龄化支出，随着时间的推移使用了两种相互竞争的定义——一种基于无法进行日常生活活动（ADL），另一种基于更主观的全球活动受限指数（GALI）。随着寿命的延长，测量的不一致以及需求强度定义方面的问题将变得越来越重要。本文通过分析一项大型欧洲样本调查来研究这两种测量方法是如何关联的，在该调查中，受访者对两个问题都进行了回答。这使得能够对这两种测量方法进行校准，并研究它们的重叠和差异区域。本文最后提出了一种简单的新的4级护理需求测量方法，该方法通过结合这两个指标，引入了护理强度的一些分级。使用一种包含强度的一致测量方法，如本文所提议的方法，将有助于国际比较、改进长期支出预测，并有助于政策讨论，包括最佳实践的推广。
