Determinants of use of care in Slovenia and Austria

DET_CAREMIX

PROJECT CO-ORDINATOR

Ricardo Rodrigues

PROJECT TEAM AT THE EUROPEAN CENTRE

Rahel Kahlert, Selma Kadi, Stefania Ilinca, Gudrun Bauer

EXTERNAL PROJECT CO-ORDINATOR

Valentina Hlebec, University of Ljubljana (Slovenia)

PROJECT PARTNERS

University of Ljubljana (Slovenia)

Institute for Economic Research (Slovenia)

BACKGROUND

Like most countries in Europe, Austria and Slovenia rely heavily on the family for the provision of long-term care (LTC). They differ however, as to the nature and scope of support provided to family carers (more generous in Austria, while in Slovenia family is the carer “by default”). This study uses the different institutional settings between the two countries to explore the determinants of care use, both in terms of type of care (e.g. informal vs. formal care) and tasks provided.

AIMS

To gain a better understanding of how older people make their choices regarding care, namely, who provides care and what type of tasks; what are the factors impacting their choices (e.g. cultural values, financial constraints, preferences, household composition); how these factors are themselves shaped by public policies; and whether they are different between groups of LTC users (e.g. socio-economic condition).

METHODS

Mixed methods including qualitative and quantitative research methods on secondary (e.g. international surveys and national data) and primary data (semi-structured interviews); stakeholder consultation; literature reviews.

ACTIVITIES/MILESTONES

The European Centre leads or participates in the following tasks:

  • Literature review of relevant public policies in Austria and Slovenia, as well as relevant literature on the determinants of care provision.
  • Quantitative analysis of secondary data sources, namely SHARE, EU-SILC and national surveys/administrative data on LTC in both countries. Analysis will address endogeneity of informal and formal care use by employing instrumental variables and longitudinal analysis.
  • Qualitative research methods (semi-structured interviews) with a maximum variation sample of older users and their proxies in each country. Semi-structure interviews will focus on the decision to take up different types of care.

FINDINGS

  • 4 different life-course pathways into caregiving that are influenced by reciprocal exchanges in the family, parallel life transitions (e.g. divorces, retirement), accumulation of disadvantages and the life trajectories of siblings.
  • Ideals of care among dyads practicing a care-mix in Austria reflect a strong role for the family but go beyond this and include e.g. involvement of care users in decision-making
  • Different types of unmet needs exist despite the combination of informal and formal care. These pertain to how care is provided (e.g. timing of care, quality of care) and the possibility to develop caring relationships.  
  • Familialistic LTC systems reinforce gender and socio-economic inequality in care provision and use, and we found no evidence that generous cash benefits have a sizeable effect in counteracting such inequalities
  • Higher socio-economic position for both households and individuals confers more choice with respect to care arrangements: higher income households are better able to purchase care services on the market and replace care provided by family, while lower educated women are more likely to provide intensive and burdensome care, which often affects employment prospects.
  • Informal care provision interacts with other public policies, namely increasing statutory retirement age, although this interaction depends on carers’ socio-economic position.

The European Centre for Social Welfare Policy and Research supports the Sustainable Development Goals

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