Soins résidentiels pour les personnes âgées en Belgique
Authors: Van den Bosch Karel , Willemé Peter , Geerts Joanna , Breda Jef , Peeters Stéphanie , Van de Sande Stefaan , Vrijens France , Van de Voorde Carine , Stordeur Sabine 
Published: January 2025

ABRÉVIATIONS 5 -- INTRODUCTION 7 -- 1. GENERAL OVERVIEW OF LONG-TERM CARE ORGANISATION AND FINANCING IN BELGIUM 8 -- 1.1. ORGANIZATION AND FINANCING OF LONG-TERM CARE 8 -- 1.1.1. LTC benefits in kind and in cash 9 -- 1.1.2. Trends in LTC supply and use 12 -- 1.1.3. LTC financing 17 -- 1.2. DESCRIPTION OF REGIONAL DIFFERENCES IN PROGRAMMING AND ELIGIBILITY CRITERIA 20 -- 1.2.1. Diverging development of residential beds within the Belgian regions 20 -- 1.2.2. Programming criteria of the three regions for the residential care sector 22 -- 1.2.3. Accreditation procedure and criteria for the residential care sector 25 -- 1.2.4. Eligibility criteria for admission to residential care 26 -- 1.2.5. Programming and development of service flats and home care services 26 -- 1.3. CONCLUSION 28 -- 2. A REVIEW OF LONG-TERM CARE PROJECTION MODELS 29 -- 2.1. INTRODUCTION 29 -- 2.2. LITERATURE SEARCH 29 -- 2.2.1. Search strategy 29 -- 2.2.2. Results 29 -- 2.3. LTC MODELS: SYNTHESIS OF RESULTS 30 -- 2.3.1. Types and characteristics of models 30 -- 2.3.2. Databases used in models 32 -- 2.3.3. Variables 33 -- 2.3.4. Regional estimates of demand for / use of long-term care 36 -- 2.3.5. The model of the Federal Planning Bureau 37 -- 2.4. PROJECTION RESULTS 38 -- 2.4.1. Introduction 38 -- 2.4.2. Baseline projections 40 -- 2.4.3. Decomposition of the growth in LTC 41 -- 2.4.4. Scenarios 41 -- 2.4.5. Recent projections for Belgium 47 -- 2.5. CONCLUSIONS 50 -- 2.6. LESSONS LEARNED AND ADDED VALUE OF THE CURRENT PROJECT 51 -- 3. A REVIEW OF THE DETERMINANTS OF LONG-TERM CARE USE BY OLDER PEOPLE 52 -- 3.1. INTRODUCTION 52 -- 3.2. LITERATURE SEARCH 52 -- 3.3. MODELS AND METHODS 52 -- 3.3.1. Considerations and limitations 52 -- 3.3.2. Research designs and methods of analysis 53 -- 3.3.3. The Andersen behavioural model 53 -- 3.4. LITERATURE REVIEW: RESULTS 54 -- 3.4.1. Predictors of nursing home admission for the general population 57 -- 3.4.2. Predictors of nursing home admission in dementia 59 -- 3.4.3. Gender differences in nursing home placement 60 -- 3.4.4. Length of stay in, and exit from nursing home 60 -- 3.4.5. Predictors of formal home care use 60 -- 3.5. CONCLUSIONS 61 -- 3.6. LESSONS LEARNED AND ADDED VALUE OF THE CURRENT PROJECT 62 -- 4. SELECTION OF DATABASES 63 -- 4.1. INTRODUCTION 63 -- 4.2. DATA REQUIREMENTS OF THE PROJECT 63 -- 4.3. EXISTING DATABASES 63 -- 4.3.1. The Permanent Sample of Socially Insured Persons (EPS) 63 -- 4.3.2. The Health Interview Survey (HIS) 64 -- 4.4. CONCLUSION 65 -- 5. MODEL SPECIFICATION 66 -- 5.1. INTRODUCTION 66 -- 5.2. GENERAL OUTLINE OF THE PROJECTION MODEL 66 -- 5.3. STEP 1: PROJECTION OF ABSOLUTE NUMBERS BY AGE AND SEX 67 -- 5.4. STEP 2: PROJECTION OF THE PROPORTIONAL DISTRIBUTION OF LIVING SITUATION -- (AVAILABILITY OF INFORMAL CARE) 67 -- 5.5. STEP 3: PROJECTION OF THE PROPORTION IN DISABILITY BY AGE AND SEX 67 -- 5.6. STEP 4: PROJECTION OF LONG-TERM CARE USE BY AGE AND SEX 68 -- 5.7. THE PROJECTION MODEL IN SUMMARY 69 -- 6. MODEL OF DISABILITY USING HIS 2004 DATA 71 -- 6.1. DATA 71 -- 6.1.1. Dependent variable: ADL limitations: 71 -- 6.1.2. Independent variables 72 -- 6.1.4. Estimation approach 73 -- 6.2. RESULTS OF THE LOGISTIC REGRESSIONS 74 -- 6.3. PREDICTION OF DISABILITY IN THE EPS 75 -- 7. MODELLING TRANSITIONS IN LONG-TERM CARE SITUATIONS, USING THE EPS 76 -- 7.1. INTRODUCTION 76 -- 7.2. DATA PREPARATION 76 -- 7.2.1. Selection of the working sample 76 -- 7.2.2. Dependent variable: construction of the LTC situation typology 77 -- 7.2.3. Independent variables 78 -- 7.3. ESTIMATION STRATEGY 79 -- 7.4. RESULTS 81 -- 7.4.1. Transition tables 81 -- 7.4.2. Results of binary and multinomial logistic regressions 83 -- 7.4.3. Predictive validity of the model for residential care 84 -- 8. PROJECTION RESULTS 88 -- 8.1. INTRODUCTION 88 -- 8.2. OVERALL EVOLUTION, BASE SCENARIO 88 -- 8.3. EVOLUTION BY PROVINCE, BASE SCENARIO 92 -- 8.4. ALTERNATIVE SCENARIOS 94 -- 8.4.1. Alternative scenarios on disability 94 -- 8.4.2. Alternative scenarios on household situation 96 -- 8.4.3. Alternative scenario on home care 97 -- 8.4.4. The scenarios compared 98 -- 9. OVERALL CONCLUSIONS 100 -- 9.1. RESIDENTIAL CARE CAPACITY REQUIREMENTS 2010-2025 100 -- 9.2. GEOGRAPHICAL VARIATION 101 -- 9.3. SENSITIVITY TO ALTERNATIVE ASSUMPTIONS ABOUT DISABILITY AND LIVING -- SITUATION 101 -- 9.4. EXPANDING HOME CARE INSTEAD? 101 -- 9.5. THE PROJECTIONS IN LONG-TERM PERSPECTIVE 102 -- 9.6. STAKEHOLDER MEETING 103 -- 10. REFERENCES 105