A Cross-National Comparison
Chapter 4: Governing Formal Care Services: Between Integration and Fragmentation
Within the overall context of governing home care, the area of formal care services has an ambivalent position. Compared to other areas of governance, particularly informal care, formal care services are much less inclusive in quantitative terms. As Table 4.1 illustrates, across our countries the expenditure on formal care services is well under 1 per cent of GDP and thus well below the expenditure on other welfare services such as health care. Yet Table 4.1 Expenditure on long-term home care as a percentage of GDP, 2000 Country Estonia Germany Italy Japan Netherlands New Zealand Sweden UK US Total long-term care1 expenditure n/a 0.47 0.582 0.02 0.61 0.12 0.82 0.41 0.33 Notes 1. The notion of ‘long-term care’ used in a national context can be substantially broader, e.g., by including residential homes for older people (e.g. Netherlands, Nordic countries). 2. Estimated public spending on long-term care (1992–95) as a percentage of GDP. Long-term care spending refers to the care needed to help older persons to lead an independent life, at home or in an institution. It excludes informal help. For home care, it should include all home care services, including district nurse services, excluding medical visits. For institutions, it includes all the costs related to care and lodging, including help for all self-care activities, but excluding medical costs. Source: International Reform Monitor (nd); OECD (2005b). 68 CHAPTER 4 22/5/07 09:09 Page 2 Governing formal care services 69 Table 4.2 Public and private expenditure on long-term home care as a...
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