The Role of Housing in Sustainable European Long-Term Care Systems

Abstract

There is evidence of benefits from the national health insurance systems in the EU Member States in the case of better-adjustment of housing units to the functional capacities of older adults. Still, the systematic approach to evaluating the social value (SV) of investments in specialised housing and other types of built environment is not yet developed. This paper aims to show how these benefits can be quantified if we evaluate the actuarial present value (APV) of reducing public expenditures in Long-term care (LTC), including Health care (HC) in these systems, after the development of specialised housing units which can accommodate the declined functional capacities of seniors. The paper presents steps to measure the SV as the impact of investments in the properly built age-friendly public housing stock, creating positive externalities for HC expenditures and LTC systems achieved for the Health Insurance Institute of Slovenia, thereby decreasing expenditures for this body. We developed a new model to forecast the SV of investments in specialised social housing as savings for national health and care systems, particularly the Central-European health and care insurance systems. We were forecasting the different demands for different specialised housing as part of the social infrastructure for insured older adults, which mitigates public expenditure on HC and LTC services. The multistate transitions are described based on projections and probability-weighted cashflows (actuarial present value, APV) are calculated. Unfortunately, there are no documents by the European Commission yet, although the Commission stresses the need to develop such a model.