European Journal of Ageing

, Volume 9, Issue 1, pp 27–37 | Cite as

Transitions in formal and informal care utilisation amongst older Europeans: the impact of national contexts

  • Joanna GeertsEmail author
  • Karel Van den Bosch
Original Investigation


The objective of this study was to explore how long-term care systems, and in particular the incorporation of needs-based entitlements to care services or benefits, influence formal and informal care utilisation dynamics. We used the Survey of Health, Ageing and Retirement in Europe (SHARE) wave 1 and 2 data, restricting the sample to persons 65+ from 9 European countries (N = 6,293). The effects of changes in health and household composition on formal and informal care transitions were estimated using logistic regression, allowing these effects to vary across countries. The results indicated that, in all countries, formal and informal care were more often complements than substitutes. The likelihood of becoming a formal or informal care user varied significantly between countries. In the Scandinavian countries and in several continental European countries with needs-based entitlements, the transition to formal care was strongly related to informal support being or becoming unavailable. We found little evidence of country differences in the effect of health variables on the transition to formal care. The analysis suggested that, whilst rates of formal care utilisation continue to differ considerably between European countries, formal care allocation practices are not very dissimilar across Northern and continental European welfare states, as we found evidence for all countries of targeting of older persons living alone and of the most care-dependent older people.


Long-term care Longitudinal analysis Informal care Formal home care SHARE 



This article uses data from SHARE release 2.3.1, as of July 29th 2010. SHARE data collection in 2004–2007 was primarily funded by the European Commission through its 5th and 6th framework programmes (project numbers QLK6-CT-2001-00360; RII-CT-2006-062193; CIT5-CT-2005-028857). Additional funding by the US National Institute on Aging (grant numbers U01 AG09740-13S2; P01 AG005842; P01 AG08291; P30 AG12815; Y1-AG-4553-01; OGHA 04-064; R21 AG025169) as well as by various national sources is gratefully acknowledged (see for a full list of funding institutions). A preliminary version of this article was presented at the 63rd Annual Scientific Meeting of the Gerontological Society of America in November, 2010 in New Orleans. The authors would like to thank the anonymous referees and the guest editor for their helpful suggestions.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Federal Planning BureauBrusselsBelgium
  2. 2.University of Antwerp, Research Unit on Welfare and the Welfare StateAntwerpBelgium
  3. 3.University of Antwerp, Herman Deleeck Centre for Social PolicyAntwerpBelgium

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