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WORKSHOP AGIR
THE HAGUE
FEBRUARY 14-15 2003
RESULTS FOR BELGIUM – WP2
J. MESTDAGH – M. LAMBRECHT
Aaaaa&&
Federal Planning Bureau
Economic Analysis &
Forecasts
WP2 - Results Belgium
TABLE OF CONTENTS
• Demand for (use of ) health care
• Long term care at home / in institutions
• Supply of health care
• Household composition / family situation
• Labour market developments
Hospital admissions
Average number of admissions, 1998, by age and gender
Highest at age 0, then decrease, to increase again with age Women are less frequently admitted except at age 15-34
0.000.200.400.600.801.001.201.40
0-1 1-4 5-9 10-14
15-24
25-34
35-44
45-54
55-64
65-74
74+
men
w omen
Hospital admissions (2)Average number of admissions – 1991 – 1998, by gender / age
Increase between 1991-’98 for younger and older age groupsDecrease between 1991-’98 between age 1 and 45
0.0
0.2
0.4
0.6
0.8
1.0
1.2
0-1 1-4 5-9 10-14 15-24 25-34 35-44 45-54 55-64 65-74 74+
men 1991
men 1998
women 1991
women 1998
Length of hospital stay Average length of hospital stay by age group and gender, 1998
Positive relation with age : increases as people get olderHigher for women than for men, especially in oldest age group
02468
10121416
0 1-4 5-9 10-14
15-24
25-34
35-44
45-54
55-64
65-74
75+
men
w omen
Length of hospital stay (2)
Average length of hospital stay by age group / gender, 1991-98
Decrease between 1991-1998, men/women, all age groups
0.0
5.0
10.0
15.0
20.0
25.0
0-1 1-4 5-9 10-14
15-24
25-34
35-44
45-54
55-64
65-74
74+
men 91
men 98
women 91
women 98
Volume of hospital stay
Volume of hospital stay, 1998, by gender and age
0
1
2
3
4
5
6
7
0 1-4 5-9 10-14
15-24
25-34
35-44
45-54
55-64
65-74
75+
men
w omen
Volume of hospital stay (2)
Volume of hospital stay, by age and gender, 1991 – 1998
Slight decrease between 1991 and 1998, all ages
0
1
2
3
4
5
6
7
8
0 1-4 5-9 10-14
15-24
25-34
35-44
45-54
55-64
65-74
75+
men 91
men 98
women 91
women 98
Contacts with doctorAverage number of contacts a year, by age group and gender,
2001 (National Health Survey)
Number of contacts increases with age Higher for women than for men (except youngest age group)
0
2
4
6
8
10
12
14
0-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75+
Men
Women
Contacts with doctor (2)Contacts with doctor by gender and age, 1997- 2001 (NHS)
Again positive relation with ageFor men and women, more contacts in 2001 than in 1997,
EXCEPT: women in oldest age group (!!)
0
2
4
6
8
10
12
14
16
18
0-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75+
men 97
men 01
women 97
women 01
Long term care at home % of population using LTC at home by age group, 1998 – 2001
Clear positive relation with age : increases as people get olderLittle evolution in time, only small increase for oldest group
0
5
10
15
20
25
30
0-59 60-74 75-79 80-84 85-89 90-94 95+
1998
2001
Long term care at home (2)% of population using LTC at home, 2001, by category
Positive relation with age, % increases as people get older% lower for higher degrees of dependence (cfr. Institutions)
0
2
4
6
8
10
12
60-74 75-79 80-84 85-89 90-94 95+
Bathroom
A
B
C
Long term care at home (3)
% of population using home-delivered meals, age / gender, 2001
Positive relation with age; % increases as people get olderNo clear difference between men and womenNote: similar data for 1997 (no increase or decrease in use)
0
5
10
15
20
25
60-64 65-69 70-74 75-79 80-84 85+
men
w omen
Long term care at home (4)
% of population receiving help in household, 2001, age/gender
Positive relation with age; % increases as people get olderHigher for women than for men, in all age groups
0
5
10
15
20
25
30
35
0-14 15-24 25-34 35-44 45-54 55-64 65-74 75+
men
w omen
LTC in institutions (2)
% of population living in ROB-RVT by age group, 1996-2001
Positive relation with age; % increases as people get older Increase between 1996-2001, especially at older ages
0
10
20
30
40
50
60
70
80
0-59 60-74 75-79 80-84 85-89 90-94 95+
1996
2001
LTC in institutions (3)
% of population in ROB-RVT, by age group and category, 2001
Positive relation with age; % increases as people get older In older age groups, categories with higher dependence become
more important
05
1015202530354045
75-79 80-84 85-89 90-94 95+
O
A
B
C
Forecasting exercise
• Use of long term care at home 2030-2050
Increase of 124%: 277.432 people in 2050 compared to 123.566 in 2001
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000
<60 60-74 75-79 80-84 85-89 90-94 95+
2001
2030
2050
Forecasting exercise (2)
• Use of LTC in institutions, 2030-2050
Increase of 166%: 317.979 people in 2050 compared to 119.254 in 2001
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
<60 60-74 75-79 80-84 85-89 90-94 95+
2001
2030
2050
Supply of formal health care
Density of care givers (per 1000 inhabitants)
Slight increase in density for all, especially nurses
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
1995 1996 1997 1998 1999 2000
General practitioner
Specialists
Pharmacist
Nurses
Physical therapistis
Supply of formal health care (2)Density of care givers in ROB-RVT (per 1000 people
living in institutions)
0
20
40
60
80
100
120
140
160
180
1996 1997 1998 1999
carers
nurses
physical therapist
paramedical staff
Supply of formal health care (4)
Number of hospital beds for LTC per 1000 inhabitants aged 65+
Decrease in density of hospital beds for LTC
7.2
7.4
7.6
7.8
8
8.2
8.4
1990 1991 1992 1993 1994
Supply of formal health care (5)
Density of acknowledged beds in ROB-RVT per 1000 inhabitants older than 65
Overall slight increase in densityDecrease for ROB, increase for RVT
0
10
20
30
40
50
60
70
80
1996 1997 1998 1999 2000
ROB
RVT
ROB + RVT
Average household size
Average household size 1900 – 1999
Decrease from 4.3 in 1900 to 2.4 in 1999
2.0
2.5
3.0
3.5
4.0
4.5
1900 1910 1920 1930 1947 1961 1970 1981 1991 1999
Number of HH members
Evolution in share of households 1930-2001
Increase in proportion HH with 1 / 2 membersProportion of bigger families decreases
0
5
10
15
20
25
30
35
1 2 3 4 >=5
1930
1970
2001
32 31
11
25 25
16 1714
21
7
Composition by marital status
% of men by marital status, 1965 – 2001
Increased proportion single and divorcedSmaller proportion married or widowed
0
10
20
30
40
50
60
Single Married Divorced Widow ed
1965
1981
2001
Composition by marital status (3)
Marital status by age group, MEN, 2001
0102030405060708090
100
Single
Married
Divorced
Widowed
Composition by marital status (4)
Marital status by age group, WOMEN, 2001
0102030405060708090
100
Single
Married
Divorced
Widowed
Composition by relation with others
Total population, 1961 – 2001
Increase in single with or without childrenDecrease in married with or without childrenSimilar situation for men and women separately
05
101520253035404550
single w ithoutchildren
single w ithchildren
marriedw ithoutchildren
married w ithchildren
1961
1981
200117
34
7 12
3024
46
30
Elderly people
% of HH having elderly person living with them
Decrease between 1970 and 2001
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
1970 1981 1998 1999 2001
Elderly people (2)
Living situation of elderly people in 199163.48
40.43
5.91.3 1.6 1.2
24.6
6.71.0
7.01.7
32.1
0
10
20
30
40
50
60
70
Alone Together Withparents(in law)
withchildren
with non-relatives
othersituation
65-74
75+
Participation rates
Participation rates, MEN, by age group, 1947-2050
Reversed U shape curveDecrease between 1947 and 2050, especially youngest and
oldest age groups
0
10
20
30
40
50
60
70
80
90
100
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-99
1947
2050
Participation rates (2)Participation rates, WOMEN, by age group, 1947-2050
Shape curve has changed from flat to reverse U-shape Increase between 1947 and 2050 except youngest and oldest
age groups
0102030405060708090
100
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-99
1947
2000
2050
Weekly working hours
Average weekly working hours, by gender, 1983-2000
Higher for men (38 in 2000) than women (30)Decrease for women, rather stable for men
30
32
34
36
38
40
Men
Women
Weekly working hours (2)
% of MEN working certain hours a week, 1983-2000
05
10152025303540
1-10 11-20 21-30 31-34 35-36 37-38 39-40 >40
1983
2000
Weekly working hours (3)
% of WOMEN working certain hours a week, 1983-2000
Increase in lowest groups (part time employment!)Decrease in highest age groups
0
5
10
15
20
25
30
35
1-10 11-20 21-30 31-34 35-36 37-38 39-40 >40
1983
2000
Part time employment
PT employment in % of total employment, by gender
Spectacular increase for women (from 5 to 30%)
0
5
10
15
20
25
30
Men
Women
Part time employment (2)
% PT employment by gender and age group, 1999
Much higher for women than for men (all ages)For men, higher in lower and higher age groups
0.010.020.030.040.050.060.0
14-1
9
20-2
4
25-2
9
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60+
Male
Female
Reasons for PT employment
Reasons for PT employment,by gender, 2000, % of PT workers giving this as reason
05
101520253035
No
FT
foun
d
Chi
ld c
are
Per
sona
l/fam
ily
No
FT
wan
ted
Oth
er
Res
t
Women
Men
CONCLUSIONS
• Demand for health care increases with age
• Demand for LTC increases with age
• Decrease in supply of formal health care
• Supply of informal health care?
- household composition
- labour market evolutions