NURSING-HOMES IN 10 NATIONS - A COMPARISON BETWEEN COUNTRIES AND SETTINGS

Aim: to illustrate demographic differences and recent trends in the pr ovision and structure of long-term care systems in the 10 countries pa rticipating in the Resident Assessment Instrument studies (Denmark, Fr ance, Iceland, Italy, Japan, The Netherlands, Sweden, Switzerland, the UK and thee USA). Method: data were assembled from government documen ts, statistical yearbooks and articles from journals; supplemental dat a on long-term care and nursing homes were solicited from colleagues. Results: All 10 countries are developed nations with high life-expecta ncies. Sweden has the oldest and Iceland the youngest population in th is study, with Japan showing the highest ageing rates over the next th ree decades. Between 2 and 5% of elderly people reside in nursing home s. Interestingly, Iceland, as the 'youngest country' in this study, ha s the highest rate of institutionalization (living in residential or n ursing homes) , while the 'oldest country' (Sweden) has a low rate of institutionalization. In all countries the support ratio (number of el derly people per 100 younger adults) is high and increasing rapidly. C onclusions: no relation appears to exist between the ageing status of a country and the number of nursing home beds. Institutionalization ra tes among the nations studied differ even more, due at least in part t o differences in the organization and financing of long-term care serv ices, in the amount of responsibility assumed in the care for disabled elderly people by each sector and the availability of long-term care beds. Facing a rapid ageing of their population, many countries are in the process of health and social care reforms.