Projects / Programmes
PLANNING THE HOME AND FACILITY-BASED CARE DYNAMICS USING THE MULTIPLE DECREMENT APPROACH
| Code |
Science |
Field |
Subfield |
| 7.00.00 |
Interdisciplinary research |
|
|
| Code |
Science |
Field |
| S215 |
Social sciences |
Social problems and welfare, national insurance |
| Code |
Science |
Field |
| 5.02 |
Social Sciences |
Economics and Business |
multiple decrement model, ageing, facility-based care, long-term care, home-care
Researchers (1)
| no. |
Code |
Name and surname |
Research area |
Role |
Period |
No. of publicationsNo. of publications |
| 1. |
28680 |
PhD David Bogataj |
Urbanism |
Head |
2016 - 2018 |
350 |
Organisations (2)
Abstract
The objective of this research is to introduce the model and to develop the proper database for planning long-term care services and housing for older population, including home-care, based on a multiple decrement/multi-state transition model, when a higher standard can be achieved by implementing flexible Equity Release Scheme (ERS) products. ERSs influence the purchasing power of seniors and therefore the probability of transitions in the decrement models is changing.
1. As the central objective, the multiple decrement approach will be developed and applied for the first time in the program of housing and accompanying services needed for older citizens as a new tool for better forecasting the logistics and housing needs of senior citizens with decreasing functional capacities, and therefore the changing services and housing needs over their lifetime horizon.
2. The Flexible Equity Release Scheme will be developed tied with the person and not with his/her housing unit, as a novelty in the scientific and professional literature, and the schemes will be embedded in the directed graph of multiple decrement. The impact of higher purchasing power in case of using reverse mortgage benefits will be evaluated, especially the impact on the probability of transitions in optimal adjustments to the needs of seniors when their functional capacities are reduced.
"Long-term care is a range of services required by persons with a reduced degree of functional capacity, physical or cognitive, and who are consequently dependent for an extended period of time on help with basic activities of daily living (ADL), such as bathing, dressing, eating, getting in and out of bed or chair, moving around and using the bathroom. This is frequently provided in combination with basic medical services such as help with wound dressing, pain management, medication, health monitoring, prevention, rehabilitation or services of palliative care. Long-term care services also include lower-level care related to help with instrumental activities of daily living (IADL), such as help with housework, meals, shopping and transportation. Long-term care can be received in institutions or at home" (Source: OECD Health Data 2008).
The project will provide an overview of the required capacities for long-term care (LTC) in both Europe and Slovenia, particularly the government’s and local authorities’ needs and responses to a growing demand for LTC services. In the context of ageing societies, the importance of long-term care is growing in all EU countries, where spending on long-term care as a share of GDP rises with the share of the population that is over 80 years old. Trends in severe disability among elderly populations across OECD countries are increasing rapidly, and the number of elderly that need assistance in carrying out activities of daily living is also growing, and by 2050 it is projected to be 3 times higher than today (OECD, 2009). It will offer also the financial solutions for a higher standard of care. Thus, it is also important for local authorities, social care and spatial planners to study elderly people's logistics, other care and housing needs. The needs of senior citizens may be satisfied if the supply networks and housing stock are specifically designed to meet their physical, emotional, recreational, medical, and social needs. Recognizing that urban space and rural areas must be adapted to meet these objectives, the research will examine the issues regarding physical improvements of elder-care networks depending on housing dispersion in the supply areas. The net present value of supply and elder-care in general at different dispersions of housing will be modelled.
Significance for science
(1) The exploratory inquiry we help us answer the question "What matters most to Slovenian seniors regarding long-term care and their housing?" We shall contribute a comparative study of perceptions and attitude of USA and Slovenian seniors about the barrier in functional capacities. The results of the research of Debra Dobbs (2015) will be compared with our results, which will provide the basis for evaluating how much USA practice can be directly implemented in the Slovenian society. Debra Dobbs published her paper on this topic recently, and our comparative study based on her work will be a novelty for Europeans.
(2) Based on our previous development of the model, invited and published recently at Springer's series "Springer Proceedings in Mathematics and Statistics" (Bogataj et al., 2015), we shall further develop the multi-state transition model for decreasing functional capacities measured by the international care dependency scale (CDS). There is no paper which would embed CDS in a multi-state transition model or multiple decrement tables.
(3) The findings at (1) and (2) above will help us to join the multi-state transition model with the table of optimal housing regarding (1) and (2), and the optimal structure of services for seniors. This model is also a novelty.
(4) Flexible reverse mortgage will be developed, linked with the person (senior) and not with the housing unit, which is also a novelty in the existing literature.
(5) The flexible reverse mortgage model will be combined with the states in the graph of multiple decrements. The simulation approach will be used to show how increasing the purchasing power of seniors as a result of implementing reverse mortgage products, and how the fiscal policy regarding financial flows of seniors would change the probability of transitions in model (3), which is another novelty of the project.
(6) Model of collecting data from the various institutions on the national level (SORS) will be a new contribution to "silver" economy.
Significance for the country
More efficient management of societal resources in the aging society
1. As stated in the recommendation of International Association of Gerontology and Geriatrics (2008) "it is important to recognize the need for a range of specialized housing options for this population, and to maximize opportunities for older people to age in place in their own home. In addition, systems that allow seamless movement through home care, day care, respite programs, assisted living, group housing, palliative and hospice care, and nursing homes may be advantageous". The multiple decrement model will allow for evaluating how many different kinds of these facilities will be needed in the future.
2. Introduction of a maximum possible flexibility of ERS products would bring new customers to the financial institutions, which are currently deterred because the current ERS financial products (available in some countries but not in Slovenia) seriously reduce the set of available choices in the life-cycle of senior citizens.
3. The information provided by multiple decrement models enables better management of cash flows in the asset portfolio and, moreover, allows for financial institutions to prepare more attractive and flexible ERSs, tailored to senior citizens’ needs. For this purpose
the methodology for construction of a database and public records (which need to be produced by national and EUROSTAT statistics) as well as
some changes to national legislation will be proposed, which today fails to provide efficient management and safe products for seniors.
Developed public records can (a) improve the prediction of the capacity needed to care for the elderly Europeans/Slovenian cohorts, and in this respect also the projection of all the needs of human resources for servicing the seniors at various levels of their functional capacities, and the demographic projections of their physical and cognitive functional abilities. It enables also forecasting the educated profiles of human resources, which are not available today.
Contribution to the new national, European and OECD's statistical methodology, which is needed but not developed yet Based on the available Slovenian data, dispersed across different Slovenian institutions, we shall develop the methodology how to collect these data on the level of Slovenian statistics (SURS).
Understanding individual transitions into and out of states of disability, which should be described by a multi-state transition model severe enough to trigger LTC insurance pay-outs is essential to product pricing and development. Such data are not available in any public statistical database. But to develop the Silver Economy in EU member states, multi-state transition demographic tables on functional capacity are essential for planning long-term care on national and insurance company levels and also on regional and municipality levels where it is needed to improve the spatial planning.
Most important scientific results
Interim report,
interim report,
final report
Most important socioeconomically and culturally relevant results
Interim report,
interim report,
final report
