Working paper

Long-term care policies in practice: a European perspective

A comprehensive study of the long-term care (LTC) systems in Germany, France, Slovenia, Italy and Denmark

Publishing date
17 December 2024
SOUTHEND, ENGLAND - MAY 25: An elderly couple look out to sea from the promenade during the warm sunny weather on May 25, 2024 in Southend-on-Sea, United Kingdom. (Photo by John Keeble/Getty Images)

This paper offers a comprehensive study of the long-term care (LTC) systems in Germany, France, Slovenia, Italy and Denmark. In many EU countries, the demand for LTC services already exceeds supply. Without major reforms, this ‘care gap’ is likely to widen further because of population ageing. This paper highlights a number of recent reforms to reduce this care gap by affecting the demand for and supply of long-term care services. We find that most measures to increase the supply of formal LTC services focus on workforce attractiveness. By examining recent policy efforts and reforms, we aim to understand in which direction LTC policy is going, and to showcase measures to prepare for the future increase in demand for care.

We thank Axel Boersch-Supan, Elsa Perdrix, Cristiano Gori and participants in a BB-Future workshop in Madrid, 11-12 September 2024, for helpful comments and discussion. Funded by the European Union as part of the BB-Future project that has received funding from the European Union’s HORIZON Research and Innovation Actions under grant agreement No. 101093849. Views and opinions expressed are however those of the author(s) only and do not necessarily refl ect those of the European Union or the European Research Executive Agency. Neither the European Union nor the granting authority can be held responsible for them.

About the authors

  • Svend E. Hougaard Jensen

    Svend E. Hougaard Jensen is a Non-Resident Fellow at Bruegel. He is also a Professor of Economics at the Department of Economics at Copenhagen Business School (CBS) and Director of the Pension Research Centre (PeRCent) at CBS. From 2017-2021, Svend was Chairman of Bruegel’s Scientific Council.

    Svend holds an MSc in Economics from the University of Aarhus, an MA in Economics from the University of Manchester, and a PhD in Economics from the London Business School.

    Svend’s research has focused on topics such as generational and macroeconomic effects of changing demographics, public and private pensions, fiscal policy in the eurozone, sustainability and management of public debt, financial stability, structural reforms, and macroeconomic policy in general.

    He has published numerous articles in learned journals and books. He has also written or edited several books, including Fiscal Aspects of European Monetary Integration (CUP), Using Dynamic General Equilibrium Models for Policy Analysis (Elsevier), Uncertain Demographics and Fiscal Sustainability (CUP), Reform Capacity and Macroeconomic Performance in the Nordic Countries (OUP), and The Danish Pension System: Design, Performance and Challenges (OUP).

    Svend has contributed to many agency and government reports, and he has served as a consultant to the World Bank and the European Commission. He also regularly writes op-ed articles published by newspapers and magazines.

    He has considerable experience as a member of advisory bodies. Currently, he is a Member of the Research Council of the Network for Studies on Pensions, Aging and Retirement (Netspar) in the Netherlands, and he has been a Member of the Danish Council for Research and Innovation Policy and a  Member of the Systemic Risk Council in Denmark.

    Homepage:  https://www.shj.cbs.dk/

  • David Pinkus

    David Pinkus joined Bruegel as an Affiliate fellow in May 2023. He is an applied economist with a strong interest in social welfare policies, as well as the intersection of financial markets and the real economy.

    His work focuses on the challenges social security systems face due to an ageing population. He is also interested in the wider economic effects of funded pension systems and institutional investors. From 2014 to 2016, he worked as a consultant at the OECD’s Long-Term Investment Project, researching policies to enable institutional investors to finance infrastructure under a G20 mandate.

    David holds a PhD in Economics from Copenhagen Business School and is affiliated with the university’s Pension Research Centre (PeRCent). David also holds an M.Sc. in Economics from Bocconi University in Milan and a B.Sc. in Economics from Ludwig-Maximilians-University in Munich.

    David is fluent in German, French and English.

  • Nina Ruer

    Nina works at Bruegel as a research assistant. She holds a Master's of Research (MRes) in Analysis and Policy in Economics from the Paris School of Economics (PSE). Her master's thesis, titled "The Gender Pay Gap in Student Employment in France," was a comprehensive study that delved into income disparities among university students in France. Prior to that, she earned a B.Sc. in Economics with a final year in "Magistère" from Université Paris 1 Panthéon-Sorbonne.

    Prior to joining Bruegel, she was a research assistant on a series of projects funded by PSE where she gained hands-on experience in finding and cleaning replication datasets for Randomized Control Trials (RCTs). She also developed multiple surrogate index functions for long-term forecasting. Another set of projects focused on collecting subjective forecasts, where she assessed the calibration of various groups for forecast accuracy.

    Nina is a dual Dutch and French citizen and is a French native speaker, fluent in Dutch and English.

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