societal change, care need and long-term care workforce in selected european countries

Societal Change, Care Need and Long-term Care Workforce in Selected European Countries

NEUJOBS WP 12 Health care, goods and sevices for an ageing population

Johannes Geyer2nd NEUJOBS Validation Event: Employment 2025 - How Will Multiple Transitions Affect the European Labor Market?

1 Long-term care workforce

Johannes Geyer2nd NEUJOBS Validation Event2

• Long-term care is provided by informal and formal caretaker

• Depending on the institutional settings, the long-term care system relies more or less on formal care

• In most countries, informal care (family) is the main source for people in need of care

• Demographic ageing increases the share of people in need for care and – at the same time – decreases the informal care potential

• The impact on the formal workforce depends on country specific settings and assumptions on the future development

1 Research agenda


What is the impact of societal change on the demand for and supply of formal care?

Detailed analysis for five countries Germany Denmark Italy Poland Slovakia

1 Tasks


A Employment situation in institutional long-term care and professional home care services

B Impact of demographic change

C Impact of changing household structures, family structures and living arrangements on the

demand for formal care

D Impact on employment

Johannes Geyer52nd NEUJOBS Validation Event

1 Need of care and care giving arrangements

2 Long-term care workforce – current situation

3 Future development of factors influencing the long-term care workforce and demand for care; and changes in labour supply

4 Discussion

Outline

1Dependency rates (in %) by age groups in selected countries (2010)


1Age-structure of the dependend population in selected countries (2010)


Denmark: 0.37 Mio.Germany: 7.9 Mio.Italy: 3.1 Mio.Poland: 2.5 Mio.Slovakia 0.48 Mio.Total: 14.3 Mio.

1 Formal and informal care arrangements


Total(in 1000) Total at home in institutions Total Informal Care No Care

2010 2010 2010 2010 2010 2010Denmark 371 46,5 34,6 11,9 53,5 5,0 48,5Germany 7847 31,0 21,4 9,6 69,0 41,5 27,5Italy 3143 31,3 19,0 12,3 68,7 128,4 * 0,0Poland 2490 3,6 0,1 *** 3,5 96,4 48,8 47,6Slovakia 475 24,6 17,6 7,0 75,4 12,0 ** 63,4Total 14326 26,5 17,4 9,1 73,5 59,9 26,7*) 2003; **) 2010;***)2006.Source: Eurostat, EU SILC; OECD Health Data; calculation of DIW Berlin.

Informal or no careFormal care recipients

Informal caregiver


1

Males Females Total Males Females Total Males Females Total Males Females Total

regular personal care to someone inside the household

3,79 5,52 4,60 5,14 7,58 6,31 7,23 10,44 8,88 8,59 10,58 9,66

personal care to someone outside the household almost daily

0,66 1,35 1,03 1,36 3,85 2,72 2,89 6,07 4,64 1,26 3,42 2,49

Source: SHARE wave 1 and 2 (Poland wave 2 only); pooled data, weighted; calculation of DIW Berlin.

Denmark Germany Italy Poland

Share of people aged 50+ providing


2

Long-term care workforce – current situation

2Employment in residential care and social work activities I


Total nuring homes Total for elderly and disabled

EU27 13243 4521 1381 4876 1465 22640 217182Denmark 188 122 200 509 2703Germany 2855 1110 491 891 311 4855 39737Italy 1268 223 86 203 74 1694 22967Poland 705 96 20 123 43 924 16131Slovakia 108 27 6 25 20 160 2351

EU27 6,1 2,1 0,6 2,2 0,7 10,4 100Denmark 7,0 4,5 7,4 18,8 100Germany 7,2 2,8 1,2 2,2 0,8 12,2 100Italy 5,5 1,0 0,4 0,9 0,3 7,4 100Poland 4,4 0,6 0,1 0,8 0,3 5,7 100Slovakia 4,6 1,1 0,3 1,1 0,9 6,8 100Source: Eurostat; LFS; calculation of DIW Berlin.

Share of sectoral employment in total economy in %

Employment in 1000 persons

Residential care Social work without accommodationHuman health and social work activities Total economyCountry

Human health Total

2Employment in residential care and social work activities II


• In 2011 about 80% of all employees in residential care and social work were females (EU average)

• In the selected countries, their share ranges from 70% in Germany to more than 90% in Slovakia

• The share of older workers (55+) is about 16% (EU average). In the selected countries: • Nursing homes: 9% (PL) 27% (SVK)

• Social work: 12% (IT) 18% (PL)


3

Future development of factors influencing the long-term care workforce

Demographic development


• Rising life-expectancy• Constant dependency rates: an increase in life-expectancy leads

to a higher share of people with impairments in ADL

• Fertility rates• Have an influence in the long-run on the informal care potential;

but less relevant for the projection until 2025

• Changing living arrangements• Constant age/gender-specific probability of being a caregiver,

taking into account changing living arrangements

• Increase in single households (exception SVK with a decline in single households)

3

3Demographic devolpment 2010 – 2025 (by demographic scenario)


2010Friendly Tough Friendly Tough Friendly Tough

in 1000

Denmark 228 312 261 85 34 37,2 14,9Germany 4.181 6.197 5.169 2.016 988 48,2 23,6Italy 3.478 5.091 4.356 1.613 878 46,4 25,3Poland 1.257 1.627 1.333 370 75 29,4 6,0Slovakia 147 207 171 60 24 40,6 16,0Total 9.291 13.435 11.290 4.144 1.999 44,6 21,5EU27 23.284 32.587 27.489 9.303 4.205 40,0 18,1

Oldest old (80 years old and older)

Source: Huisman et al. (2013); calculation by DIW Berlin.

2025 Changes 2025/2010 Changes 2025/2010

in 1000 in 1000 in %

3People (65+) with impairments in ADL in selected countries 2010 - 2025


2010Friendly Tough Friendly Tough Friendly Tough

in 1000

Denmark 90 110 118 20 28 22,6 31,8Germany 3909 4316 4844 407 935 10,4 23,9Italy 2085 2516 2787 431 702 20,7 33,7Poland 1254 1679 1853 425 598 33,9 47,7Slovakia 235 322 353 87 119 37,3 50,6Total 7572 8943 9955 1370 2383 18,1 31,5Source: Huisman et al. (2013); EU SILC; calculation of DIW Berlin.

65+

2025 Changes 2025/2010 Changes 2025/2010

in 1000 in 1000 in %

3 Changes in the number of informal caregiver (50+)


2010 tough friendly tough friendly tough friendly

Denmark 90 101 106 11 16 12,27 17,52Germany 2 476 2 729 2 875 253 399 10,21 16,11Italy 2 704 3 261 3 402 557 698 20,59 25,81Poland 1 385 1 448 1 535 63 150 4,55 10,83

Denmark 21 22 23 2 2 7,60 11,48Germany 864 948 980 83 116 9,64 13,42Italy 1 090 1 333 1 376 244 286 22,35 26,26Poland 325 339 349 15 25 4,49 7,68

Denmark 70 79 83 9 13 13,65 19,30Germany 1 612 1 781 1 894 170 283 10,52 17,55Italy 1 615 1 928 2 027 313 412 19,39 25,50Poland 1 061 1 109 1 186 48 125 4,56 11,80Source: SHARE wave 1, 2, and 4; weighted and pooled data; Huisman et al. 2013; calculation of DIW Berlin.

Informal caregiver inside the household

2025 Changes between 2010 and 2025

in 1000 persons in %Informal caregiver total

Informal caregiver outside the household

3Changes in number of recipients of formal care 2010 - 2025


tough friendly tough friendly

Denmark 42 48 57 6 15 15,0 35,0Germany 743 875 1 036 132 293 17,8 39,4Italy* 354 447 513 93 159 26,3 44,9Poland 140 161 177 21 37 15,2 26,6Slovakia 37 43 46 7 10 17,7 26,1

Denmark 177 208 234 31 57 17,5 32,0Germany 576 671 785 95 209 16,5 36,3Italy* 597 692 752 95 155 15,9 26,0Poland 149 179 205 30 56 20,1 37,5Slovakia 26 35 38 9 12 34,6 46,2

Germany 1 182 1 299 1 474 117 292 9,9 24,7Italy* 498Slovakia 57 67 72 10 15 17,5 26,3

friendly

*) In Italy most severe disabled persons receive a special transfer (universal cash benefit) to cope with the care expenditure which is often used to engage privat financed caretakers.

Source: Schulz (2013); Coda Moscarola (2013); Golinowska et al. (2013); Radvansky and Lichner (2013); calculation of DIW Berlin.

Recipients of formal home care

Recipients of cash benefits for informal care at home

Recipients of institutional care

2025 Changes between 2010 and 2025

in %absoluteCountries 2010

tough

3Changes in demand for formal long-term care workforce (national statistics)


Friendly Tough Friendly Tough Friendly Tough

Denmark 140 163 185 24 46 17,06 32,62Germany 952 1117 1318 165 366 17,33 38,45Italy* 334 387 420 53 86 15,87 25,75Poland 72 84 93 11 20 15,77 28,08Slovakia 25 31 33 6 8 21,83 30,56*) Only staff in residential care

Source: Schulz (2013); Coda Moscarola (2013); Golinowska et al. (2013); Radvansky and Lichner (2013); calculation of DIW Berlin.

in 1000

Changes 2025/20102010

Countries2025

in %

3Changes in employment between 2010 and 2025 (NEMESIS)


Employment by sectors - results of the NEMESIS model

Country totalNon market

services

Health care and social work (Q)*

Human health (Q86)*

Residential care and

social work (Q87+88)*

Denmark -1 64 33 11 22Germany -3 459 -246 -355 -309 -47Italy -323 -999 -292 -214 -79Poland -531 358 91 69 21Slovakia 83 4 1 1 0total -4 231 -818 -523 -441 -82

Denmark 107 126 64 22 42Germany 161 2020 491 132 359Italy 2 149 - 18 -5 -4 -1Poland 810 1 016 258 197 61Slovakia 251 96 25 19 5total 3 478 3 239 832 366 466*) Estimation of DIW Berlin with the exception of Germany.

Employment (in 1000)

Changes between 2010 and 2025 tough scenario

Changes between 2010 and 2025 friendly scenario

Source: Boitier, B., Lancesseur, N. and Zagamé, P. "Global scenarios for European socio-ecological transition", NEUJOBS Deliverable D9.2, 2013, for scenarios results; calculations of DIW Berlin.

3Changes in demand for long-term care workforce and supply of residential care and social work 2010 - 2025


demand* supply** demand* supply**Denmark 17,1% 6,6% 32,6% 12,9%Germany 17,3% -2,7% 38,5% 20,9%Italy*** 18,7% -17,7% 31,2% -0,3%Poland 15,8% 9,9% 28,1% 28,1%Slovakia 21,8% 0,9% 30,6% 18,8%

Tough scenario Friendly scenario

*) Demand for formal long-term care workforce based on national statistics. -**) Results of the NEMESIS model for the sector non-market services; Germany for residential care and social work.-***) Change in dependent people as a proxy for formal labour demand.Sources: Boitier et al., 2013; Schulz, 2013; Coda Moscarola, 2013; Golinowska et al., 2013; Radvansky and Lichner, 2013; calculation of DIW Berlin.


4

Discussion

Summary & Discussion I


• Projection of demand and supply of long term care workforce• Assumptions:

• constant utilization rates

• No behavioral adjustments

• No changes in the long-term care system

• Informal care remains the main pillar of the long-term care system in all countries with the exception of Denmark

• We expect an increase of dependent people until 2025; the number of potential carer increases as well.

• The supply of formal care has to increase by 17% (tough) or 35% (friendly)

• In general: the demand for long-term care grows stronger than labor supply in this sector

4

4 Summary & Discussion II


Possible strategies to increase the supply of long-term care in the future:

a) Measures to increase informal care

b) Measures to increase the formal care workforce

c) Recruitment of long-term care workers from abroad

4 Summary & Discussion III


a) Measures to increase informal care• Improve reconciliation of employment and informal care provision• Training, counselling• Increase the share (and amount of care provided) of male caregiver

b) Measures to increase the formal care workforce• Making jobs more attractive: wages, flexible working hours, reduction

of part-time jobs, career opportunities• Increase productivity by using more ICT

c) Recruitment of long-term care workers from abroad

Vielen Dank für Ihre Aufmerksamkeit.

DIW Berlin — Deutsches Institutfür Wirtschaftsforschung e.V.Mohrenstraße 58, 10117 Berlinwww.diw.de

Dr. Anika RasnerPhone: +49 30 89 789 235Email: [email protected]

societal change, care need and long-term care workforce in selected european countries

Documents

residential care

care need

health care

care system

informal care family

supply of formal care

formal workforce

selected countries