Long-term Care for the Elderly in the Corona Crisis

24.03.2020

A First Analysis by WIFO Deputy Director Ulrike Famira-Mühlberger

Long-term care service providers have been particularly challenged since the onset of the corona crisis. Their customers are among the most vulnerable group. In addition, the personnel bottlenecks that already existed in advance are causing problems. The deputy director of WIFO, Ulrike Famira-Mühlberger, outlines the current challenges in the care sector in an initial economic analysis.

Due to the increasing incidence of the diseases, it is foreseeable that nursing staff will also be more affected by Covid-19. A massive expansion of tests for nursing staff, but also for persons in care – especially those in nursing homes – is urgently needed in order to separate the affected persons in time.

Another topic that is being worked on at full speed is the entry point for 24-hour care workers. About 33,000 people in need of long-term care in Austria are dependent on their deployment. This crisis shows Austria's dependence on foreign care workers who provide care for those in need of long-term care in Austria at low hourly wages.

If no satisfactory solution can be found with the countries of origin but also with the countries through which people travel (above all Romania, Slovakia and Hungary), alternative solutions must be worked out. The same applies if relatives providing care are no longer able to provide care due to Covid-19 disease. This can be an expansion of mobile services (in case this is possible in terms of personnel), but also alternative care quarters for persons in need of care who can no longer be cared for by 24-hour care or by their own family. If such alternative solutions have been found, then ongoing testing is of utmost importance due to the spatial concentration of highly vulnerable persons. Making 100 million € available for emergency care is an important step by the Austrian federal government. The same applies to the flexible handling of the funding for 24-hour care.

Furthermore, it is necessary to recruit "replacement staff" for the care sector. These can be – in addition to the already "extended" and "recalled" civilian servicemen – persons who have been dismissed by the developments of the last 10 days or will be dismissed in the near future. From this reservoir, the PES should specifically address persons in cooperation with care service providers. An analysis of the data on unemployed persons as of the end of February 2020 also shows a small reservoir of persons who were unemployed as of the end of February and indicate nursing professions as their career aspiration. These persons must also be specifically addressed. A simplification of bureaucracy, the applicable standards and a reduction in documentation requirements will probably be necessary during the Corona Crisis in order to maintain the system of long-term care provision.

The Corona Crisis also highlights two problems in the organisation of long-term care provision in Austria: the lack of an interlinking of health and long-term care and the complexity of the care system with divergent financing and task responsibilities of the various local authorities. In a subsequent long-term care reform, unbundling will be required here, which will make financing from a single source possible. Better coordination between the state units or local authorities involved – i.e. between those who can determine the rules in the care sector and those who are responsible for its implementation and, in part, for its financing – is a prerequisite for sustainable financing of care.
 

Publications

WIFO Working Papers, 2019, (580), 20 pages
Online since: 16.04.2019 0:00
Projections show sharp increases in public spending on long-term care services across Europe. However, a purely cost based focus on long-term care services is economically misleading. Private and public expenditure on long-term care services directly and indirectly generate income in the form of salaries, taxes and social security contributions. The aim of this paper is to quantify the economic impact and multipliers of long-term care services for the first time. Based on an econometric regional input-output model for Austria, we estimate the direct, indirect and induced effects of public and private expenditures on value added, employment, taxes and social security contributions. According to our results, each Euro spent on long-term care services is associated with domestic value added of 1.7 € as well as 0.70 € in taxes and social security contributions. The economic multipliers of the long-term care services are comparatively high due to the high share of wages and salaries in direct expenditure and the associated high direct value added. Public expenditure on professional care services should therefore not be regarded merely as a cost factor in the public budget. Rather, this rapidly growing economic sector is also an increasingly important economic factor in a time of ageing societies.
WIFO-Monatsberichte, 2019, 92(3), pp.149-157
Online since: 25.03.2019 0:00
 
In Österreich berichten Pflegedienstleister zunehmend über Schwierigkeiten, Pflegepersonal für mobile und stationäre Dienste zu finden. Neben der Frage der künftigen Finanzierung ist die Frage der Sicherstellung ausreichender Personalabdeckung wohl das dringlichste Problem im Pflegebereich. Wie eine Schätzung auf Basis aktueller Projektionen zur Nachfrage nach Pflegedienstleistungen zeigt, werden im Bereich der mobilen und stationären Pflege und Betreuung bis 2030 rund 24.000 (Vollzeitäquivalente: 18.000) und bis 2050 79.000 (Vollzeitäquivalente: 58.000) zusätzliche Pflegekräfte benötigt (Stand 2016: 63.000 bzw. 45.000 Vollzeitäquivalente). Im Mittelpunkt einer Pflegereform müssen deshalb neben Ausbildungs- und Umschulungsoffensiven Maßnahmen stehen, die den Pflegeberuf attraktiver machen.
Monographs, December 2018, 113 pages
Commissioned by: Hilfswerk Österreich
Study by: Austrian Institute of Economic Research
Online since: 17.12.2018 11:59
 
Der vorliegende Bericht beleuchtet die derzeitige und künftige ökonomische Bedeutung mobiler Pflege- und Betreuungsdienste in Österreich vor dem Hintergrund des bevorstehenden demographischen Wandels und möglicher politischer Maßnahmen zur Veränderung des Versorgungsmix in der formellen Pflege. Die Studie zeigt einerseits den Status quo mobiler Dienste im nationalen und internationalen Kontext auf und gibt analog zu einer Reihe von weiteren rezenten WIFO-Studien Einblick in den projizierten, österreichweiten Leistungsumfang mobiler Dienste und der Pflegedienste insgesamt bis zum Jahr 2050. Darauf aufbauend wird versucht, in vier Politikszenarien (Verschiebung des Versorgungsmix zugunsten der stationären Pflege, der 24-Stunden-Betreuung und der mobilen Dienste, relative Erhöhung des Potentials für informelle Pflege) die Effekte möglicher Maßnahmen zu quantifizieren, die die Bedeutung der jeweiligen Pflegeformen in unterschiedlichem Ausmaß beeinflussen. Eine Reihe von evidenzbasierten Schlussfolgerungen und Argumenten zeigt abschließend die Bedeutung mobiler Dienste als integraler Bestandteil eines effektiven Pflegesystems auf.
Please contact

Ulrike Famira-Mühlberger, PhD

Function: Senior Economist, Deputy director
Research groups: Labour Market, Income and Social Security
© Cristian Newman/Unsplash
© Cristian Newman/Unsplash