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Wiener, J.M., Tilly J., & Cuellar, A.E. (2003). Consumer-Directed Home Care in the Netherlands, England, and Germany. PPI Issue Paper #2003-12. AARP Public Policy Institute, Washington, DC.

Abstract

To help understand the implications for the U.S. long-term care system, AARP commissioned a study to describe and analyze consumer-directed (CD) home care programs in the Netherlands, England, and Germany. Information for this study comes from in-person interviews with key stakeholders (including government officials and representatives of consumer organizations) in each country, and extensive literature searches.
Key findings
1. LTC services, including home care, are funded primarily through social insurance programs (not means tested) in Germany and the Netherlands, and through means-tested programs in England.
2. Consumers in all 3 countries choose between agency-directed and CD services.
3. CD programs in all 3 countries are used by persons of diverse ages and levels of disability.
4. The 3 countries provide only modest assistance to help consumers cope with administrative tasks inherent in consumer direction.
5. All 3 countries are grappling with labor force issues.
6. The CD approach is attractive to governments because of its lower per-person costs.
7. In Germany and the Netherlands, a very significant share of consumers chooses to use the funds to pay family members. (This is restricted in England.)
8. Despite some concerns about quality of services, the 3 countries have taken minimalist approaches to monitoring quality.

Obtain the Full Version

Available as: In-Brief (2 pages)\r\n\r\nThe 86 page FULL report is available at the link below.\r\n\r\n\r\n\r\n

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