The presentation by Eurofound highlighted a few general lessons from the recent report on ‘access to healthcare services in times of crisis’.[1] The report also looked into long-term care, and the interaction between health and social services. It highlighted that sometimes people experiencing poverty turned to primary care services, because they would not know where otherwise to turn-to. It also mentioned that the crisis in principle accelerated cost-saving measures which could also improve quality of life, such as keeping older people longer in the community, and out of expensive hospital beds and nursing homes. But, the crisis has not been a good environment to improve alternative home and community services. The report also found that the crisis has resulted to some decreases in nursing home care demand, with older people contributing with their pensions to household income of their children.

Two case studies in the country reports[2] written for this Eurofound study, were presented:

Latvia:During the crisis, cuts were concentrated on salaries and social benefits because thesewere thelargest part of nursing home expenses. Cuts affected also accessibility of health care because some services were discontinued. Health and social care became to some extent less integrated during the crisis.

Hungary:During the economic crisis, resources were reduced and the need of the population for health and social care has increased. At local level there are some examples where an integrated care approach prevails with complex care plans made by multidisciplinary teams (Platán nursing home). Integrated care models aim to optimalize budget allocation, rationalize capacity planning and run transparent operation by enhanced information and communication.

From the discussions in the breakout groups various themes emerged:

  • Care should really be needs-based, to provide good quality care and be economically sustainable. This can be stimulated by users allocating their own care-budgets, or by money following the user. Overall, needs-assessment is a challenge.
  • Health and social services integration is a challenge. It could be good if planning were done jointly by health and social care, with an integrated administration, and joint training may also help. Social services have generally been cut more during the crisis.It is not only health and social services which need to be integrated better, but also other types of services. Effective cooperation can save resources, and people receive the type of care they need.
  • The importance of effective home care by social and health care professionals was highlighted. It also allows people to be effectively rehabilitated after hospital discharge, and its potential to contribute to creating of employment.
  • Family is an important factor in long-term care, in particular in NMS and Mediterranean countries. But, its role has come from different historical importance in these two country groups, and in all countries its role is becoming weaker, partly because of changing habits and norms and because people are having fewer children. While such informal care should be supported, it is a challenge when more responsibilities are shifted to families, with these changing roles.

[1]

[2] Please contact you wish to receive the unpublished country reports.