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What is the impact of policy differences on nursing home utilization?: the cases of Germany and the Netherlands

Alders, Peter, Costa-Font, Joan ORCID: 0000-0001-7174-7919, de Klerk, Mirjam and Frank, Richard (2015) What is the impact of policy differences on nursing home utilization?: the cases of Germany and the Netherlands. Health Policy, 119 (6). pp. 814-820. ISSN 0168-8510

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Identification Number: 10.1016/j.healthpol.2015.02.006


Though need factors would predict a higher rate of institutional use in Germany, in 2004 the percentage of people over 65 in institutions in the Netherlands was almost double the percentage in Germany. The lower nursing home utilization in Germany coincided with lower out-of-pocket costs, de facto means-testing of social assistance for such care, a lower perceived quality of nursing home, and less acceptance of the nursing home as a main care modality for adults experiencing functional impairments. These factors have developed over time and are consistent with a–relatively - large government responsibility toward care for the elderly and a preference for institutional care over home care in the Netherlands. The policy to encourage older adults to move to elderly homes to decrease the housing shortage after WWII might have had long-lasting effects. This paper points out that a key in the success of a reform is a behavioral change in the system. As there seems to be no single factor to decrease the percentage of older adults in nursing homes, a sequence of policies might be a more promising route.

Item Type: Article
Official URL:
Additional Information: © 2015 Elsevier Ireland Ltd
Divisions: European Institute
Social Policy
Centre for Economic Performance
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RT Nursing
Date Deposited: 20 Feb 2015 14:38
Last Modified: 20 Oct 2021 02:15
Projects: QLK6-CT-2001-00360, SHARE-I3, RII-CT-2006-062193, COMPARE, CIT5- CT-2005-028857, SHARELIFE, CIT4-CT-2006-028812, SHARE-PREP, N° 211909, SHARE-LEAP, N° 227822, SHARE M4, N° 261982, U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, R21 AG025169, Y1-AG-4553-01, IAG BSR06-11 and OGHA 04-064
Funders: European Commission through the 5th Framework Programme, 6th Framework Programme, 7th Framework Programme, U.S. National Institute on Aging, German Ministry of Education and Research

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