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  • 3 - Who should be eligible for long-term care in older age? Policy trade-offs and implications for coverage, equity and wellbeing

  • Edited by Jonathan Cylus, European Observatory on Health Systems and Policies, George Wharton, London School of Economics and Political Science, Ludovico Carrino, University of Trieste, Stefania Ilinca, World Health Organization, Manfred Huber, World Health Organization, Sarah Louise Barber, World Health Organization
  • Book:
    The Care Dividend
    Published online:
    21 March 2025
    Print publication:
    03 April 2025, pp 48-120
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  • Summary

    This chapter examines the challenges in measuring long-term care needs to determine eligibility and the impact of eligibility rules on access to care and wellbeing, focusing on European countries with established long-term care systems. Eligibility rules are crucial for identifying individuals with the greatest need and ensuring equitable resource distribution, yet defining these rules is challenging due to the lack of a universal approach to measuring health and social needs. Consequently, some individuals with functional or cognitive limitations may be inadequately supported or face high out-of-pocket costs, leading to reliance on informal care or unmet needs. This can reduce their independence and increase the risk of costly hospitalizations. The chapter advocates for expanding eligibility rules to improve coverage, equity, and efficiency, highlighting their role in increasing access to care, reducing poverty due to care costs, and enhancing wellbeing.