Long-Term Care Systems in Lithuania, Poland, Czech Republic and Romania

Rising demographic pressure has moved sustainable long-term care systems for elderly to the front ranks of the social policy agenda in the European Union.  CASE experts explore the systems in Lithuania, Poland, Czech Republic and Romania in 4 new publications. 

The Czech Republic is among the countries that have redesigned long-term care system according the principles of accessibility, quality and fiscal tenacity in the past couple of years. The reform process was well rooted in the practice of local governments and social sector empowering institutions that existed before 2006, when the reform was introduced.. The newly established long term care system covers a wide spectrum of services, for example, cash benefits to dependents in need via different types of social services and institutional care. Still, similarly to other countries of the Central and Eastern Europe region, long term care is disintegrated between the social system and health care.  The system is also not free from critique, it fails to  formally define the meaning of long term care, lacks in the integration of services, suffers from shortage and poor quality of services. Thus, despite state efforts, care for the elderly remains a family responsibility.

Poland belongs to the EU group of countries with the family based welfare model. In the social sector, the significant changes that were favorable to LTC services development were introduced by the law on the social assistance (2004) and family benefits (2003) widening the scope of care available at home and in adult day care centers. But still the provision of services is insufficient and a market of private services, paid out-of-pocket is rapidly developing.
The formal LTC system in Lithuania is still biased towards the provision of institutional care, despite the fact that a number of social projects have started in order to expand the supply of semi-stationary LTC and care provided in homes. Similarly to the previous cases, most care provided to the elderly and disabled is still carried out by family, neighbors, friends and volunteers.

At this moment, Romania still does not have an integrated long term care system. There are social and medical services that are run, provided and legislated independently. The current national strategy is to coordinate these services and to create an integrated system.

Long-Term Care Reports were published as part of the Assessing Needs of Care in European Nations - ANCIEN project, a 3.5 year initiative funded by the  Seventh Framework Program (Health Cooperation Program) of the European Commission.  CASE experts are implementing the project along with other members of the European Network of Economic Policy Research Institutes (ENEPRI).