Figure 1 LTC users as share of the population, 2008
Total LTC- Home care Institutional
use use care use
Poland 0.2
Korea 0.21 0.19
Ireland 0.5
United States 0.5
Iceland 0.7
Spain 2009 0.92 0.28
United Kingdom
Italy 0.83 0.57
Canada 2007 2.00
Luxembourg 2007 1.42 0.68
New Zealand 1.61 0.49
Slovak Republic 1.49 0.61
Australia 2007 1.64 0.71
Denmark 2007 1.68 0.82
Finland 1.49 1.01
Belgium 2007 1.44 1.16
Germany 1.90 0.90
Czech Republic 2.4 0.4
Japan 2007 2.1 0.6
United Kingdom 2.9
Netherlands 2007 2.32 1.48
Norway 3.00 0.90
Switzerland 2.78 1.12
Sweden 2.83 1.35
Austria (total) 5.1 5.1
2.0028826 0.7806923 2.783575
Notes: Data for Australia, Canada, Luxembourg, Denmark, Belgium and the Netherlands refer to 2007; data for Spain refer to 2009;
Czech home-care users include 300,000 recipients of the attendance allowance.
Polish data underestimate total LTC users.
Austrian data represent recipients of cash allowances.
Source OECD Health Data 2010, The Korean computerized administrative network and additional Australian and Swedish data.
Home care use Institutional care use
Austria (total)
Sweden
Switzerland
Norway
Netherlands
United Kingdom
Japan
Czech Republic
Germany
Belgium
Finland
Denmark
Australia
Slovak Republic
New Zealand
Luxembourg
Canada
Italy OECD
1.83 0.8
Spain
average
Iceland
United States 2.3%
Ireland
data for Spain refer to 2009; Korea
Poland
% of population
ralian and Swedish data.
0 2 4 6
Figure 2. Public and total spending on LTC in OECD countries, share of GDP, 2008
2008 Total 2008 Total
LTC Public LTC Private LTC LTC Total LTC
expenditure expenditure, expenditure, expenditure expenditure,
Total exp. on % GDP % GDP Total exp. on % of GDP
LTC % GDP (2008) (2008) LTC % GDP (2050)
Portugal 2006 nursing 0.1 0.1 0.2
Czech Republic nursing 0.2 0.2 0.6
Slovak Republic 2006 0.2 0.2 0.5
Hungary nursing 0.3 0.3 0.5
Korea 0.2 0.1 0.3
Poland 0.4 0.4 0.9
Spain 0.6 0.2 0.8 1.4
Australia 2005 total 0.8 0.2 1
United States nursing 0.6 0.4 1
Slovenia 0.8 0.3 1.1
Austria nursing 1.1 0.2 1.3 2.5
Germany total 0.9 0.4 1.3 2.3
Luxembourg 2005 1.4 1.4
New Zealand 1.3 0.1 1.4
OECD 1.2 0.3 1.5 1.40 2.4
Canada nursing 1.2 0.3 1.5
Japan 1.4 0.2 1.6
France 1.7 1.7 2.2
Iceland nursing 1.7 1.7
Belgium nursing 1.7 0.2 2 2.9
Denmark 2007 nursing 1.8 0.2 2 3.4
Switzerland 2007 nursing 0.8 1.3 2.1
Finland 1.8 0.4 2.2 4.2
Norway nursing 2 0.2 2.2 4.5
Netherlands 3.5 3.5 8.2
Sweden 3.6 3.6 5.5
Notes: Data for Austria, Belgium, Canada, the Czech Republic, Denmark, Hungary, Iceland, Norway, Portugal, Switzerland and the United
States refer to only health-related long-term care expenditure. In other cases, expenditure relates to both health-related (nursing) and social
long-term care expenditure. Social expenditures on LTC are estimated at 1% of GDP (Source: Czech Ministry of Health, 2009). Data for
Iceland and the United States refer to only to nursing long-term care in institutions. Data for the United States underestimate expenditure
on fully private LTC arrangements. Data for Poland exclude infrastructure expenditure, amounting to about 0.25% of GDP in (2007). Data
for the Netherlands do not reflect user co-payments, estimated at 8% of total AWBZ expenditure in (2007).
Source: OECD Health Data 2010.
Public LTC expenditure, % GDP (2008)
Private LTC expenditure, % GDP (2008)
0.5
1.5
Total LTC expenditure,% of GDP (2050)
2.5
3.5
Sweden
4.5 Netherlands
5.5
6.5
Norway
7.5 Finland
8.5 Switzerland
9.5
10.5
Denmark
11.5 Belgium
12.5
13.5
Iceland
14.5 France
15.5 Japan
16.5
17.5 Canada
18.5 OECD
19.5
20.5
New Zealand
21.5 Luxembourg
22.5 Germany
23.5
24.5 Austria
Slovenia
United States
Portugal, Switzerland and the United
oth health-related (nursing) and social
Australia
Ministry of Health, 2009). Data for Spain
d States underestimate expenditure
about 0.25% of GDP in (2007). Data
Poland
007). Korea
Hungary
Slovak Republic
Czech Republic
0 2 4 6 8
8 10
Figure 3 The share of the population aged over 80 years old will increase rapidly in OECD countries
80 + 1950-2050 world population projections
1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964
USA 0.011 0.012 0.012 0.012 0.013 0.013 0.013 0.013 0.014 0.014 0.014 0.014 0.015 0.015 0.015
Korea 0.004 0.004 0.003 0.003 0.003 0.003 0.003 0.003 0.004 0.004 0.002 0.003 0.003 0.003 0.003
Japan 0.004 0.005 0.005 0.005 0.005 0.006 0.006 0.006 0.007 0.007 0.007 0.007 0.008 0.008 0.008
EU27 0.011 0.011 0.012 0.012 0.012 0.013 0.013 0.014 0.014 0.014 0.015 0.015 0.015 0.016 0.016
OECD 0.010 0.010 0.010 0.011 0.011 0.011 0.011 0.012 0.012 0.012 0.012 0.013 0.013 0.013 0.013
Brazil 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003
China 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.004 0.004 0.004 0.004 0.004
World 0.006 0.006 0.006 0.006 0.006 0.006 0.006 0.006 0.006 0.006 0.006 0.006 0.007 0.007 0.007
Source: OECD Labour Force and Demographic database
OECD EU27 Japan Korea
18%
USA World Brazil China
16%
14%
12%
10%
8%
6%
4%
2%
0%
Source: OECD Labour Force and Demographic Database, 2010.
1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982
0.016 0.016 0.017 0.017 0.017 0.018 0.019 0.019 0.020 0.020 0.021 0.022 0.022 0.022 0.023 0.023 0.023 0.024
0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.004 0.004 0.004 0.004 0.005 0.005 0.005 0.005
0.008 0.008 0.008 0.009 0.009 0.009 0.009 0.010 0.010 0.010 0.011 0.011 0.012 0.013 0.013 0.014 0.015 0.016
0.016 0.017 0.017 0.017 0.018 0.018 0.018 0.019 0.019 0.019 0.020 0.020 0.021 0.021 0.022 0.023 0.023 0.024
0.014 0.014 0.014 0.015 0.015 0.015 0.016 0.016 0.016 0.017 0.017 0.018 0.018 0.018 0.019 0.019 0.020 0.021
0.003 0.004 0.004 0.004 0.004 0.004 0.004 0.004 0.004 0.004 0.005 0.005 0.005 0.005 0.005 0.005 0.005 0.005
0.004 0.004 0.004 0.005 0.005 0.005 0.005 0.005 0.005 0.006 0.005 0.005 0.005 0.005 0.004 0.004 0.004 0.005
0.007 0.007 0.007 0.007 0.007 0.007 0.007 0.008 0.008 0.008 0.008 0.008 0.008 0.008 0.008 0.008 0.008 0.009
1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
0.024 0.025 0.025 0.026 0.026 0.027 0.028 0.028 0.029 0.029 0.030 0.030 0.031 0.031 0.032 0.032 0.032 0.033
0.005 0.005 0.005 0.005 0.006 0.006 0.006 0.007 0.007 0.008 0.008 0.008 0.008 0.009 0.01 0.01 0.01 0.01
0.017 0.017 0.018 0.019 0.020 0.021 0.023 0.024 0.025 0.027 0.028 0.030 0.031 0.032 0.034 0.035 0.036 0.038
0.025 0.026 0.027 0.028 0.029 0.030 0.031 0.031 0.032 0.033 0.034 0.035 0.035 0.035 0.034 0.033 0.033 0.034
0.021 0.022 0.022 0.023 0.024 0.024 0.025 0.026 0.026 0.027 0.028 0.028 0.029 0.029 0.029 0.029 0.029 0.030
0.005 0.005 0.006 0.006 0.006 0.006 0.006 0.006 0.007 0.007 0.007 0.008 0.008 0.008 0.008 0.009 0.009 0.009
0.005 0.005 0.006 0.006 0.006 0.006 0.006 0.007 0.007 0.007 0.007 0.007 0.007 0.008 0.008 0.008 0.009 0.009
0.009 0.009 0.009 0.009 0.010 0.010 0.010 0.010 0.010 0.010 0.011 0.011 0.011 0.011 0.011 0.011 0.011 0.011
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
0.034 0.034 0.035 0.036 0.036 0.037 0.037 0.038 0.037 0.037 0.037 0.037 0.037 0.037 0.037 0.037 0.037 0.037
0.011 0.012 0.012 0.013 0.014 0.015 0.016 0.017 0.018 0.019 0.021 0.022 0.024 0.026 0.027 0.029 0.031 0.033
0.040 0.042 0.044 0.047 0.050 0.053 0.056 0.059 0.062 0.065 0.068 0.072 0.075 0.078 0.081 0.085 0.088 0.091
0.036 0.037 0.038 0.040 0.041 0.042 0.044 0.045 0.046 0.047 0.048 0.050 0.050 0.051 0.053 0.054 0.055 0.056
0.031 0.032 0.033 0.034 0.035 0.036 0.037 0.038 0.039 0.040 0.041 0.041 0.042 0.043 0.044 0.045 0.045 0.046
0.010 0.010 0.010 0.011 0.011 0.012 0.012 0.013 0.013 0.014 0.014 0.015 0.015 0.016 0.016 0.017 0.017 0.018
0.010 0.010 0.011 0.011 0.012 0.012 0.013 0.013 0.014 0.014 0.015 0.015 0.016 0.017 0.017 0.018 0.018 0.019
0.012 0.012 0.012 0.013 0.013 0.014 0.014 0.015 0.015 0.015 0.016 0.016 0.016 0.017 0.017 0.017 0.018 0.018
2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036
0.037 0.038 0.038 0.039 0.040 0.041 0.042 0.043 0.045 0.047 0.049 0.051 0.052 0.054 0.056 0.058 0.060 0.061
0.034 0.036 0.038 0.04 0.042 0.043 0.044 0.045 0.047 0.049 0.051 0.053 0.055 0.058 0.06 0.064 0.068 0.073
0.093 0.096 0.100 0.104 0.107 0.111 0.112 0.113 0.119 0.125 0.131 0.136 0.139 0.142 0.144 0.145 0.146 0.147
0.057 0.058 0.059 0.060 0.061 0.062 0.063 0.064 0.066 0.068 0.070 0.072 0.074 0.076 0.078 0.080 0.082 0.084
0.047 0.048 0.049 0.050 0.051 0.052 0.053 0.054 0.056 0.058 0.060 0.062 0.064 0.066 0.067 0.069 0.071 0.072
0.019 0.019 0.020 0.021 0.021 0.022 0.023 0.023 0.024 0.025 0.026 0.027 0.028 0.030 0.031 0.033 0.034 0.036
0.019 0.020 0.020 0.021 0.021 0.022 0.022 0.023 0.024 0.025 0.026 0.028 0.030 0.032 0.034 0.037 0.038 0.040
0.018 0.019 0.019 0.019 0.019 0.020 0.020 0.021 0.021 0.022 0.023 0.023 0.024 0.025 0.026 0.027 0.028 0.029
2037 2038 2039 2040 2041 2042 2043 2044 2045 2046 2047 2048 2049 2050
0.063 0.065 0.066 0.068 0.069 0.071 0.072 0.073 0.073 0.073 0.073 0.073 0.074 0.074
0.078 0.083 0.089 0.095 0.101 0.107 0.112 0.117 0.122 0.126 0.131 0.135 0.14 0.145
0.147 0.148 0.148 0.149 0.149 0.149 0.150 0.152 0.154 0.154 0.157 0.160 0.163 0.167
0.086 0.088 0.090 0.092 0.095 0.097 0.099 0.101 0.104 0.106 0.108 0.110 0.112 0.114
0.074 0.076 0.077 0.079 0.081 0.083 0.084 0.086 0.088 0.089 0.090 0.091 0.093 0.094
0.037 0.039 0.041 0.043 0.045 0.047 0.050 0.052 0.054 0.056 0.058 0.060 0.062 0.064
0.041 0.042 0.044 0.045 0.047 0.049 0.051 0.054 0.056 0.059 0.062 0.064 0.068 0.072
0.030 0.031 0.032 0.033 0.034 0.035 0.036 0.037 0.038 0.039 0.040 0.041 0.042 0.043
Figure 4. The demand for LTC workers is expected to at least double by 2050
% of FTE nurses and personal carers to total projected working population
6%
FTE Chart 1
2008 2050 (pure ageing scenario)
5%
2050 (pure
2008 ageing scenario) 4%
Slovak Republic 0.2% 0.7% 3%
Czech Republic 0.5% 1.4%
Belgium 0.8% 2.0% 2%
Canada 1.0% 1.6%
1%
Australia 1.1% 2.6%
Germany 1.2% 3.1% 0%
New Zealand 1.3% 3.6%
Japan 1.5% 3.9%
United States 1.7% 2.9%
Luxembourg 1.7% 3.3%
Norway 2.6% 5.6%
Notes: For the purposes of the analysis, the number of LTC workers includes nurses and personal carers
working in an institution or at home, express on a full-time equivalent (FTE) basis. The analysis above is
limited to employed LTC workers and generally does not include other LTC workers under different working
arrangements, such as self-employed individuals. The range of occupations considered as nurses and
personal carers, as well as the definition of full-time equivalent may vary across countries.
Data for Australia, New Zealand and the United States refer to 2007. Data for Canada and Luxembourg refer to 2006.
(1) Refers to institutions only.
Source: OECD calculations based on OECD Health Data 2010, EC (2009) Ageing report and OECD Labour Force and Demographic database, 2010.
Figure 5. More mental health problems among carers
total men
Carers with Non-carers Carers with Non-carers
mental with mental Ratio of mental with mental Ratio of
health health Carers/Non- health health Carers/Non-
problems problems carers problems problems carers
Greece 44.8 31.1 1.4 Austria 34.6 22.8 1.6
Denmark 39.4 27.5 1.4 Netherlands 36.1 24.2 1.5
Korea 45.5 31.8 1.4 Germany 33.6 23.1 1.5
Australia 21.3 15.3 1.4 Australia 19.4 14.3 1.4
Czech Republic 46.57 34.28 1.4 Korea 32.2 24.4 1.3
Belgium 50.3 37.4 1.3 Belgium 39.2 28.0 1.3
Austria 40.0 30.2 1.3 Greece 21.5 18.6 1.3
Germany 42.9 33.3 1.3 Denmark 24.6 22.3 1.3
Netherlands 40.2 31.4 1.3 France 33.3 29.8 1.2
United Kingdom 23.1 18.8 1.2 United Kingdom 17.95 15.0 1.2
OECD (18) 41.6 33.6 1.2 OECD (18) 30.1 24.9 1.2
Spain 55.8 46.0 1.2 United States 23.6 20.5 1.1
France 52.2 43.4 1.2 Italy 39.3 35.1 1.1
Poland 73.37 62.29 1.2 Spain 30.6 29.0 1.1
Ireland 34.55 29.98 1.2 Sweden 23.5 23.8 1.0
United States 28.4 24.7 1.2 Switzerland 17.1 20.9 0.9
Sweden 32.6 31.3 1.0 Czech Republic 29.03 22.59 0.9
Italy 48.9 48.0 1.0 Poland 64.41 51.11 0.9
Switzerland 28.3 29.1 1.0 Ireland 21.15 23.09 0.9
a) Ratios correspond to the relative prevalence of mental health problems among carers and non-carers.
b) Samples include persons aged 50 and above. The United States includes care provide to parents only.
c) The following years are considered for each country: 2005-07 for Australia; 1991-2007 for the United Kingdom; 2004-2006 for other European countries; 2005 for
Source: OECD estimates based on HILDA for Australia, BHPS for the UK, SHARE for other European countries, KLoSA for Korea and HRS for the US.
Ratio of Carers/Non-carers with mental health problems
1.5
1.4
1.3
1.2
1.1
1.0
0.9
0.8
0.7
0.6
women
Carers with Non-carers
mental with mental Ratio of
health health Carers/Non-
problems problems carers
Korea 53.5 38.4 1.4
Australia 22.4 16.3 1.4
Denmark 46.1 32.3 1.4
Greece 54.4 41.6 1.3
Belgium 57.4 45.8 1.2
United Kingdom 26.9 21.9 1.2
Austria 43.2 36.5 1.2
Germany 49.5 41.7 1.2
Spain 68.3 59.0 1.2
OECD (18) 47.6 41.0 1.1
United States 31.6 28.1 1.1
France 61.1 54.3 1.1
Netherlands 42.4 37.7 1.1
Sweden 36.9 38.2 1.0
Switzerland 34.5 36.1 1.0
Italy 53.9 58.1 1.0
Czech Republic 55.41 44.15 1.0
Poland 78.68 71 1.0
Ireland 40.71 36.14 1.0
2004-2006 for other European countries; 2005 for Korea; and 1996-2006 for the United States.
KLoSA for Korea and HRS for the US.
Figure 6. The cost associated with high-care need is a large share of income for most seniors
Share of adjusted disposable income for individuals 65 years and over in different income deciles
Income Decile Country Average
France Spain US Korea Canada Netherlands
2nd decile 226.5% 228.5% 230.3% 198.6% 148.0% 119.1% 192%
4th decile 170.1% 162.3% 148.9% 122.5% 116.6% 102.5% 137%
6th decile 134.9% 122.1% 105.5% 81.9% 90.5% 85.3% 103%
8th decile 100.7% 90.5% 72.9% 52.2% 68.8% 64.6% 75%
10th decile 47.0% 45.6% 29.4% 24.7% 36.2% 34.7% 36%
250%
Share of disposable income
accounted for by LTC cost for
200% poor and rich elderly
150%
100%
50%
0%
Poorest Richest
Note: The data points represent the averages of the following countries: France, Spain, United States, Korea,
Canada and the Netherlands. High-care need is defined as 108.33 hours of care per month, at the prevailing rate
per hour, excluding public subsidies, in each respective country.
Source: OECD Secretariat calculation based on the OECD Income Distribution and Poverty Database (www.oecd.org/els/social/ine
in, United States, Korea,
month, at the prevailing rate
overty Database (www.oecd.org/els/social/inequality).