Substantial between-country differences in organising community care for older people in Europe-a review.
BACKGROUND
The European population is aging. The main drivers of public spending on health care for people of 65 years and older are hospital admission and admission to long-term care facilities. High quality community care can be a cost-effective and quality solution to respond to the impact of ageing populations on health-care systems. It is unclear how well countries are equipped to provide affordable and quality community care. The aim of this article is to describe and compare community care delivery with care-dependent older people in Europe.


METHODS
This study is conducted within the European Union-financed IBenC project [Identifying best practices for care-dependent elderly byBenchmarkingCosts and outcomes of community care (FP7)] in which six European countries are involved. To compare the community care delivery with care-dependent older people in these countries, we performed a systematic comparison of macro indicators using metadata complemented with data from multinational surveys.


RESULTS
Data on the following dimensions are described and compared: population of the country, governmental expenditures on health, sources of community health services funding, governmental vision and regulation on community care, community care organisations and care professionals, eligibility criteria for and equity in receiving care and the involvement of informal care.


CONCLUSIONS
: Because of the variations in the European community care contexts, the growing demand for community care as a cost-effective and quality solution to the care burden of aging populations will have country-specific impacts. When learning from other countries' best practices, in addition to researchers, policy makers should take full account of local and national care contexts.
1 LUCAS, KU Leuven - University of Leuven, Leuven, Belgium liza.vaneenoo@med.kuleuven.be.
Liza
L
Van Eenoo
1 LUCAS, KU Leuven - University of Leuven, Leuven, Belgium.
Anja
A
Declercq
2 Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica Sacro Cuore, Rome, Italy.
Graziano
G
Onder
3 Aging and Services, National Institute for Health and Welfare, Helsinki, Finland.
Harriet
H
Finne-Soveri
4 Department III, Economy and Law, Hochschule für Technik und Wirtschaft Berlin, Berlin, Germany.
Vjenka
V
Garms-Homolová
5 Faculty of Medicine, Icelandic Gerontological Research Institute, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland.
Pálmi V
PV
Jónsson
6 European Health Management Association, Cork, Ireland.
Olivia H M
OH
Dix
7 Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Johannes H
JH
Smit
8 Department of General Practice and Elderly Care Medicine, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.
Hein P J
HP
van Hout
8 Department of General Practice and Elderly Care Medicine, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.
Henriëtte G
HG
van der Roest
D000203:Activities of Daily Living; D000368:Aged; D000375:Aging; D003153:Community Health Services / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D005060:Europe; D005380:Financing, Government / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration; D006302:Health Services Research; D006280:Health Workforce; D006801:Humans; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D012111:Residence Characteristics / Q000706:statistics & numerical data*