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The number of beds in long-term care
(LTC) institutions and in LTC departments in hospitals provides a measure of the resources
available for delivering LTC services to individuals outside of their home. Long-term care
institutions refer to nursing and residential care facilities which provide accommodation
and long-term care as a package. They include specially designed institutions or
hospital-like settings where the predominant service component is long-term care for
people with moderate to severe functional restrictions.
On average across OECD countries,
there were 44 beds in LTC institutions and 6 beds in LTC departments in hospitals per
1 000 people aged 65 and over in 2009 (Figure 8.7.1). Sweden had the
highest number of LTC beds in 2009, with 80 beds per 1 000 people aged 65 and over in LTC
institutions, but only a small number of beds allocated for LTC in hospitals. In Italy and
Poland, there were relatively few beds in LTC institutions or in hospitals per 1 000
people aged 65 years and over in 2009. Most LTC services in these two countries are
provided at home by informal care givers (see Indicator 8.5 "Informal carers" ).
While most countries report very few
beds allocated for LTC in hospitals, some countries continue to use hospital beds quite
extensively for LTC purposes. In Korea, there are nearly as many LTC beds in hospitals as
there are in dedicated LTC institutions. However, the number of beds in LTC institutions
has increased in recent years, especially following the introduction of Korea's public
long-term care insurance programme in 2008. In Japan, there is also a fairly large number
of hospital beds that have traditionally been used for long-term care, but there have also
been recent increases in the number of beds in LTC institutions. Among European countries,
Finland and Ireland maintain a fairly large number of LTC beds in hospitals. In Finland,
local governments are responsible for managing both health and long-term care services,
and have traditionally used hospitals to provide at least some long-term care. In both
Finland and Ireland, there has been however a recent rise in the number of beds in LTC
institutions which has been accompanied by a reduction in LTC beds in hospitals.
Many other OECD countries have
developed the capacity of LTC institutions to receive LTC patients once they no longer
need acute care in hospitals, in order to free up costly hospital beds. The number of LTC
beds in institutions has increased more rapidly than the number of LTC beds in hospitals
in most countries (Figure 8.7.2). It has grown particularly
quickly in Korea and Spain, although it started from a relatively low level and still
remains well below the OECD average. In Australia also, the number of beds in institutions
has increased rapidly over the past ten years. In Sweden, both the number of LTC beds in
hospitals and in LTC institutions has declined slightly over the past decade, although the
capacity still remains the highest of all countries. Sweden has implemented various
measures in recent years to promote home-based care, including the use of cash benefits to
promote home living and the expansion of community-based LTC (Colombo et al., 2011).
Providing LTC in institutions is
generally more expensive than home-based care, if only because of the additional cost of
board and lodging. However, depending on individual circumstances, a move to LTC
institutions may be the most appropriate and cost-effective option, for example for people
living alone and requiring round the clock care and supervision (Wiener et al., 2009) or people living in remote areas with limited
home-care support.
Definition and comparability
Long-term care institutions refer
to nursing and residential care facilities which provide accommodation and long-term
care as a package. Beds in adapted living arrangements for persons who require help
while guaranteeing a high degree of autonomy and self control are not included. For
international comparisons, beds in rehabilitation centers are also not included.
However, there are variations in
data coverage across countries. Several countries only include beds in publicly-funded
LTC institutions, while others also include private institutions (both profit and
non-for-profit). Some countries also include beds in treatment centers for addicted
people, psychiatric units of general or specialised hospitals, and rehabilitation
centers.
Information on data for Israel:
http://dx.doi.org/10.1787/888932315602.
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| Indicator in PDF |
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| 8.7.1 Long-term care beds in institutions and hospitals, per
1 000 population aged 65 and over, 2009 (or nearest year) |
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| 8.7.2 Trends in long-term care beds in institutions and in
hospitals, 2000-09 (or nearest year) |
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