coordinating the network of eu agencies 2015 responses to the crisis in long-term care cases:...

Coordinating the Network of EU Agencies 2015

Responses to the crisis in long-term care Cases: Hungary and Latvia

Workshop23rd European Social Services Conference

Lisbon, 6-8 July 2015

Hans Dubois, Eurofound

http://www.eurofound.europa.eu/publications/report/2014/quality-of-life-social-policies/access-to-healthcare-in-times-of-crisis





Long-term care

• Long-term care: where social and healthcare meet…

• Definitions and structure of ‘social’ versus ‘health’ care vary, but intuitively broadly clear

• Some findings from Eurofound’s study, to feed the groups discussions…


Impact crisis on long-term care: where social & health care meet

A. Demand for primary healthcare for issues which would better be addressed by social care with some reaction by creating ‘basic services’ (Portugal);

B. cuts in social care: people having difficulties finding their way through the healthcare system (Slovenia)*;

C. cuts in home-care for elderly: increases in hospital stay, with some hospitals reacting by increasing cooperation with social services (Ireland).

Source: www.eurofound.europa.eu/publications/report/2014/quality-of-life-social-policies/access-to-healthcare-in-times-of-crisis More on the issue of non-receipt of entitlements: http://www.eurofound.europa.eu/access-to-benefits-in-times-of-crisis


http://www.eurofound.europa.eu/access-to-benefits-in-times-of-crisis

http://www.eurofound.europa.eu/access-to-benefits-in-times-of-crisis


Crisis also presented apotential opportunity

• Accelerating keeping older people in community

• Challenge 1: not need to save cost if not structurally changed, just some beds removed

• Challenge 2: crisis not ideal context for developing quality alternative community services

• Challenge 3: decreased demand for nursing homes may be caused by older people contributing with pensions to children’s household incomes

Source: www.eurofound.europa.eu/publications/report/2014/quality-of-life-social-policies/access-to-healthcare-in-times-of-crisis



Next

• Latvia: Mārtiņš Moors, with comments on the specific case of Stella Maris nursing home (7 min)*

• Hungary: Eszter Kovacs, with comments on the specific case of Platán Home nursing home (7 min)*

• Introducing & organising the breakout groups (5 min)• Group discussions (20 min)• Presenting the conclusions of the 3 groups to all (6 min)

• Wrapping-up

* For more details on these country studies, request full country reports to [email protected], or see: www.eurofound.europa.eu/publications/report/2014/quality-of-life-social-policies/access-to-healthcare-in-times-of-crisis

mailto:[email protected]



Responses to the crisis in long-term care in Latvia

Martins Moors

Deputy director, Head of Social AdministrationRiga City Council Welfare Department (member of ESN)


Organization of nursing care home (or LTC) service for older people in Latvia

• Provision of nursing care home services for older people is considered to be a social service and falls entirely under the responsibility of the municipalities.

• However, the majority of nursing homes employ some medical personnel, mainly nurses.

• Provision of medical services to nursing homes’ inhabitants is organized in the same way as the provision of medical care to the general population.

• Long term care services for persons with severe mental disorders are under the responsibility of the Ministry of Welfare and are financed from the central government’s budget.


Financing of nursing care home (or LTC) service for older people in Latvia

• Recipients of social care services must cover the cost of services or a part of it – 90% from state pension (and other income)

• The rest of the cost must be covered by this person’s primary guardian/caretaker (formula according to rules of government)

• if the guardian/caretaker is not able to do so, by the municipality.


Sources of revenues of nursing homes, 2011

14%

33%

10%

41%

1% 1%

2011State Municipality

Primary guardian/caretaker Customer

Other operating income Other revenues

Source: Ministry of Welfare (2013)


Actual and forecasted number of nursing homes customers, 2007-2012

5000

5100

5200

5300

5400

5500

5600

5700

5800

5900

6000

2007 2008 2009 2010 2011 2012

Number of customers

Number of forecasted customers

Source: Ministry of Welfare (2013)


Trends in the number of nursing homes employees, 2007-2012

0

500

1000

1500

2000

2500

3000

2007 2008 2009 2010 2011 2012

Total N of medical personell

N of doctors

Total N of employees

Source: Ministry of Welfare (2013).


Case study: nursing home Stella Maris

• Long term care centre owned by the municipality of Riga

• Stella Maris had long term care– In 2007, 107 customers; 53 employees– In 2011, 109 customers; 49 employees– In 2012, 114 customers; 53 employees


Trends in monthly spending per customer, 2007-2012 (1LVL=1,42€)

0

50

100

150

200

250

300

350

2007 2008 2009 2010 2011 2012

Spending per customer per month (LVL)

Source: Ministry of Welfare (2013).


Case study: nursing home Stella Maris expenses, 2007-2012 (1LVL=1,42€)


Actual trends now in Riga

• Almost half of LTC institution clients are people with dementia (46% in 2014 (Riga))

• Increasing number of receivers of alternative care in living area (home care, alarm button, meals on wheels, assistant) – from 3941 persons in 2009 to 6410 persons in 2014

• Increasing numbers of people with disabilities– From 40 063 persons (5,65% from Riga population) in 2009

to 47 588 persons (6,82% from Riga population) in 2014

• Lack of LTC providers in Riga and surrounding municipalities


Thank you for attention!


The cases

LatviaHungary


Introducing the break-out groups

• 3 Groups, for 20 minute discussion; chairs:1. Eszter Kovacs2. Mārtiņš Moors3. Jordi Tolrà i Mabilon

• Each group has 1 rapporteur who will at the end summarise conclusions in Max 120 seconds

• Conclusions incorporated in 1-page summary of this workshop, to be posted on-line


Questions for all break-out groups

1) What are the challenges in cooperation between social and health services in long-term care?

2) How has the crisis impacted cooperation between social and health services in long-term care?

3) Given this background, how –and in what circumstances– can cooperation between social and health services contribute to quality service delivery?


Thank you

Hans [email protected]

mailto:[email protected]

coordinating the network of eu agencies 2015 responses to the crisis in long-term care cases:...

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