Publication:
Long-Term Care and Ageing: Case Studies - Bulgaria, Croatia, Latvia and Poland

Loading...
Thumbnail Image
Files in English
English PDF (3.21 MB)
763 downloads
English Text (336.95 KB)
75 downloads
Published
2010-11
ISSN
Date
2017-08-15
Author(s)
Editor(s)
Abstract
As gains in basic health care increase life expectancy, more people live past the age of 65, a time when the risk of dementia and other degenerative diseases is higher and people are more likely to require long-term care (LTC) services. Whether at home or in an institution, such care is an important way to protect the lives and dignity of a country's elderly citizens. Unfortunately, the cost of LTC, especially in institutions, can be catastrophic for families. Without public social protection systems many people cannot afford the care they need or the high cost of care sends them and their families into poverty. Thus, LTC is not only a health issue, but also a fiscal issue and as the European population ages, it is crucial for states to develop comprehensive LTC systems that address this interrelated issue. The next section explores the demographic background of the Bulgarian population, which is one of the fastest aging in Europe. This is followed by s short-description of the macro-economic and fiscal framework in post-crisis Bulgaria. Next, an overview of LTC service provisions is given, followed by a section on financing of LTC services. The last section concludes by introducing some guiding principles for future policy reforms.
Link to Data Set
Citation
World Bank. 2010. Long-Term Care and Ageing: Case Studies - Bulgaria, Croatia, Latvia and Poland. © World Bank. http://hdl.handle.net/10986/27848 License: CC BY 3.0 IGO.
Digital Object Identifier
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Long-Term Care Policies for Older Populations in New EU Member States and Croatia : Challenges and Opportunities
    (Washington, DC, 2010-11) World Bank
    The objective of this summary report is to highlight the main lessons learned from Organization for Economic Development and Co-operation (OECD) countries with advanced Long Term Care (LTC) policies and the implications for LTC policymaking in new European Union (EU) member states and Croatia. The first section examines the main findings from the framework report on the financing, provision and regulation of LTC services. The next section presents comparative findings from the four case study countries, including the demographic context for LTC services, the main features of the financing, provision and regulation of LTC services and the strengths and weaknesses of current LTC systems there. The last section identifies policy directions for the four case study countries. In terms of LTC benefits, none of the case study countries have a universal entitlement system combining home, community and institutional care. Rather, LTC benefits, both cash and in-kind, are limited and largely associated with the social assistance system. The lack of data on LTC expenditures mainly stems from the undefined position of LTC between the health and social sectors, which makes it difficult to accurately collect data.
  • Publication
    Why Should We Care About Care?
    (World Bank, Washington, DC, 2015-04-06) World Bank Group
    Without appropriate policies to address the expected rise in the care burden, population aging can reduce womens access to economic opportunities and decelerate future growth, thereby threatening the agenda of poverty reduction and shared prosperity in Europe and Central Asia. Based on the analysis of existing and newly collected quantitative and qualitative data, several key policy recommendations can be formulated for policymakers consideration: (a) improvement of the accessibility, affordability, and quality of formal childcare and eldercare options offers a way to address challenges related to excessive reliance on informal care and to capitalize on current opportunities; (b) the design of future demographic, health, and education policy reforms should take into account any potential effects on informal care providers; (c) care leave (both paid and unpaid) can shape families choices about care and market work; (d) flexible work arrangements can function as effective alternatives to unpaid leave; and (e) care-related allowances (both in-kind and cash) aim to promote quality care for children and elders and recognize the work of caregivers but may have negative repercussions on caregivers labor force outcomes. Increased recognition of the critical role of care in aging societies and careful review of the policy environment related to formal and informal care provision can help governments to harness the full potential of demographics, thereby promoting poverty reduction and shared prosperity.
  • Publication
    Thailand's Health Workforce : A Review of Challenges and Experiences
    (World Bank, Washington, DC, 2009-11) Pagaiya, Nonglak; Noree, Thinakorn
    Thailand's health system is a dynamic entity that continues to change and grow. The country's health policies greatly affect the health workforce, the choices they make, their numbers and their availability. This paper explores the relationship between Thai health workers and the policies that affect them.
  • Publication
    What’s Next for Old Europe?
    (Washington, DC, 2015) World Bank
    Europe’s population is growing older. People are living longer and healthier lives. Wealthier European Union (EU) countries have enjoyed near‐universal access to better health care and seen public health promotion and lifestyle changes that have reduced the morbidity and mortality due to heart disease, an effort known as the “cardiovascular revolution”. As a result the EU‐15 countries enjoy an average life expectancy of 81 years. At the same time, EU‐15 countries have also witnessed a drop in fertility since the 1970s, though recently fertility has stabilized or reincreased in a number of countries.
  • Publication
    Bulgaria Health Sector Diagnosis : Policy Note
    (Washington, DC, 2012) World Bank
    The health system in Bulgaria has undergone significant transformations since the transition and it continues to evolve. This policy note updates a similar document prepared in 2009. It highlights some positive developments, particularly in the area of public health, but continues to find gaps that recent reforms have been unable to reverse. In particular: i) health status in Bulgaria is improving at a slower pace than in other European Union (EU) countries, and the burden of non-communicable diseases is particularly high; ii) coverage of preventive services is low and Bulgarians are much more frequently hospitalized than other Europeans, a sign that the system may not be producing the right mix of services; iii) Bulgarians are among the least satisfied Europeans when it comes to their health system; and iv) total health expenditure is comparable to that of countries with similar income, but the out-of pocket share is disproportionately large and has grown over time, and the financial protection provided by the system is incomplete. Whilst more public expenditure on health will be needed in the medium to long-term, any increases should be accompanied by improvements in efficiency and effectiveness in order to make the best use of resources and ensure the delivery of better health outcomes. This policy note thus primarily focuses on three areas where decisive and prompt action could rapidly bring results and improve the experience of Bulgarian citizens: hospitals, outpatient care, and drug policies. These issues are closely interlinked and tackling them is a key to the modernization of service delivery in all European countries. Indeed, in order to face the challenges brought about by ageing and non-communicable diseases and to meet the population's needs and expectations, new models of health and social care need to emerge that enable patients to stay out of hospital. This is possible through technological change, but can only happen if the outpatient sector delivers more and patients can manage diseases and risk factors through access to appropriate services and medicines.

Users also downloaded

Showing related downloaded files

  • Publication
    Remarks to the G20 Finance Ministers and Central Bank Governors Meeting
    (World Bank, Washington, DC, 2020-11-20) Malpass, David
    World Bank Group President David Malpass said that while some countries are recovering, the pandemic is still taking a terrible toll, with poverty levels rising sharply. He highlighted on the health emergency response programs in one hundred twelve countries using a fast-track mechanism that is now able to access a further window of twelve billion in funding for vaccine purchases and delivery. He also mentioned that the World Bank is already at work in cooperation with WHO, UNICEF, the Global Fund and GAVI on rapid vaccine deployment readiness assessments for one hundred countries. He spoke about IFC working in coordination with CEPI to invest a further four billion in manufacturing and distribution of vaccines and products that support vaccination programs. He recognized that fragile conflict and violence (FCV) states are most in need, and World Bank's engagement with them. Under his Presidency, the World Bank Group has invested more in climate finance than at any time in its history. He mentioned that IDA is frontloading its financing to make more resources available for the poorest countries. He highlighted on an important step that the G20 call on DSSI beneficiary countries to commit to disclose all public sector financial commitments. The Development Committee that asked the Bank and the IMF to propose more actions to address the unsustainable debt burdens of low- and middle-income countries. He concluded that the fuller transparency is the only way to balance the interests of the people with the interests of those signing the debt and investment contracts.
  • Publication
    South Asia Development Update, October 2024: Women, Jobs, and Growth
    (Washington, DC: World Bank, 2024-10-10) World Bank
    South Asia’s growth is on track to exceed earlier expectations, in a broad-based upturn. The region is expected to remain the fastest-growing among emerging market and developing economies (EMDEs). Several risks could upend this generally promising outlook, including extreme weather events, social unrest, and policy missteps, such as reform delays. But South Asian countries also have considerable untapped potential that could help them further boost productivity growth and employment and adapt to climate change. In particular, with about two-thirds of the region’s working-age women out of the labor force, raising female employment rates to those of men could increase per capita income by as much as one-half. Measures to accelerate job creation, remove obstacles to women working, and equalize gender rights would be more effective if combined with a shift toward social norms that looked more favorably on working women. Also, most South Asian countries rank among the EMDEs least open to global trade and investment. Greater openness could boost women’s employment, spur the growth of firms, and allow the region to take better advantage of the reshaping of global supply chains and trade. Reducing the cost of conducting business could help the region better harness large-scale remittance inflows.
  • Publication
    Social Gains in the Balance : A Fiscal Policy Challenge for Latin America and the Caribbean
    (Washington, DC, 2014-02-24) World Bank
    In 2012, the Latin America and the Caribbean (LAC) region continued its successful drive to reduce poverty and build the middle class. The proportion of the region's 600 million people living in extreme poverty, defined in the region as life on less than $2.50 a day, was cut in half between 2003 and 2012 to 12.3 percent. Reflecting the upward mobility out of poverty, households vulnerable to falling back into poverty became the largest group in LAC in 2005, and represent almost 38 percent of the population. However, in the last two years, the share of vulnerable households has started to decline. The middle class, currently 34.3 percent of the population, is growing rapidly and is projected to replace the vulnerable as the largest economic group in LAC by 2016. The Southern Cone region (including Brazil) continued to be the most dynamic region and the main driver of poverty reduction in LAC, while poverty in Central America and Mexico proved more stubborn. About 68 percent of poverty reduction between 2003 and 2012 was driven by economic growth, with the remaining 32 percent arising from decline in inequality. Overall, equality of access to basic childhood goods and services has improved in recent years. Yet access can be further improved, and serious issues remain concerning the quality of those goods and services, particularly in education and housing infrastructure. Moreover, access increases with parental education and income or assets, reflecting low intergenerational mobility in many countries in the region. As with poverty reduction, most of the progress in equality of access since 2000 has come in the Southern Cone and the Andean regions, while many of Central America's countries managed only small improvements. There are also severe differences at the subnational level and between urban and rural areas, highlighting the need to strengthen the capacity of local governments to deliver high quality basic services to all their citizens.
  • Publication
    World Bank East Asia and the Pacific Economic Update, October 2024: Jobs and Technology
    (Washington, DC: World Bank, 2024-10-07) World Bank
    East Asia and the Pacific, seen in the context of the world economy, stands out as a paragon of development. Despite the recent ravages of the pandemic and the persistent tensions of geopolitics, the region is growing at stably high rates and the benefits are widely shared. But compared to its own past and potential, the region’s economic performance is less impressive. Growth is still below pre-pandemic rates, except in Indonesia, and output has not yet recovered to pre-pandemic levels in several countries, especially in the Pacific. This Economic Update highlights three key developments: shifting regional growth dynamics as China’s growth slows, changing trade patterns due to global tensions, and the impact of technologies such as robots, artificial intelligence, and digital platforms on jobs. The report calls for productivity-enhancing structural reforms to strengthen domestic growth drivers through; deeper international trade agreements to foster more open and stable trade regimes; deeper technical, digital, and soft skills while addressing impediments to labor mobility, factor price distortions and expanding social protection for workers in the digital informal economy to boost productivity and employment.
  • Publication
    Digital Africa
    (Washington, DC: World Bank, 2023-03-13) Begazo, Tania; Dutz, Mark Andrew; Blimpo, Moussa
    All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.