Socioeconomic Inequity in Long-Term Care (LTC) Use and Unmet Need in Europe

Governments face great challenges in establishing long-term care (LTC) policies that are accessible, that ensure quality and that are financially sustainable at the same time. These challenges often lead to socioeconomic inequities in the use of LTC services. However, these inequities may differ across countries, based on the nature of the implemented LTC system in that country. The aim of this paper is to research horizontal inequities in LTC use and unmet need in eight European countries to i) evaluate how these inequities differ across countries to ii) compare these with the nature of the corresponding national LTC system. The horizontal inequities are measured with the concentration index. The main results show that the use of formal (informal) care is not per se positively (negatively) correlated with income. However, socioeconomic inequities in LTC use are present and indeed vary greatly between countries, while inequities in most countries seem to follow the nature of the corresponding LTC system. Finally, inequities in unmet need of LTC services are for all countries concentrated among the poor, indicating that socioeconomic status does play a role in receiving sufficient long-term care services.