New study shows trend towards person-centred and technology-supported care.

On 17 March, the European Commission published a comparative study by the European Social Policy Analysis Network (ESPAN) on long-term care facilities for older people. Based on national reports prepared by the ESPAN country teams, the study provides an overview of the care situation in the Member States, the nine (potential) candidate countries, as well as Iceland and Norway. It also identifies existing gaps in care provision and highlights potential reform approaches.

Care at breaking point

With societies ageing, the demand for long-term care is set to rise significantly. Even today, the care situation in many places is characterised by staff shortages and high costs. Against this backdrop, the authors of the study emphasise that traditional care models will not be sufficient in the long term to meet the diverse needs. Consequently, Member States are increasingly developing alternative and innovative care models that offer more flexible, person-centred and sustainable solutions. These often combine inpatient, home-based, and community-based care and place particular emphasis on promoting autonomy, social participation and continuity of care. Furthermore, many approaches incorporate digital technologies and support informal carers.

The care situation today

According to the findings, all European countries offer residential, home-based, and community-based care services. At the same time, however, there are significant differences in access to and the scope of formal care provision. A key challenge is the fragmentation of responsibilities across different levels of government and between the health and social sectors. This can disrupt care pathways, exacerbate geographical inequalities, and shift costs more heavily onto users and carers, thereby increasing reliance on informal care or undeclared care work.

Significant differences in public spending on care

In 2022, public expenditure on formal long-term care in the EU averaged 1.7 per cent of gross domestic product (GDP), with significant differences between Member States. Whilst Denmark, the Netherlands and Sweden spent three per cent or more, expenditure in 14 countries stood at one per cent of GDP or less. At 1.7 per cent, Germany was in line with the EU average. When expenditure on long-term care is set against total age-related costs – including pensions, healthcare and education – a similarly varied picture emerges. The share was highest in the Netherlands at 18.2 per cent, whilst the EU average was 7.1 per cent and in Germany 7.6 per cent.

Innovative approaches

Member States are responding to these challenges with a variety of measures. A common feature of these approaches is the shift from institutional solutions to person-centred, often community-based care models. Alternative models of residential care, for example, offer smaller, community-integrated or flexible forms of accommodation. Advanced home-care models support care provided by family members or trusted individuals. These typically include employment contracts, training, insurance cover and professional supervision. The aim is to recognise and promote informal care whilst ensuring quality. Community-based care models often combine health, social and preventive services. This is intended to improve access, reduce the number of hospital admissions and ensure coordinated, person-centred care. Technology-supported care models incorporate digital tools and information and communication systems into long-term care. They are intended to complement carers and, particularly in the home environment, improve safety, self-determination and communication.

Working Group on Adequate Social Protection in Old Age

The findings of the study will be incorporated into the work of the Working Group on Adequate Social Protection in Old Age (WG ADAGE) of the EU’s Social Protection Committee. A report on this is scheduled for mid-2027.