Population ageing is putting Europe's public long-term care systems under increasing pressure, prompting many countries to pursue ageing-in-place models that help older individuals remain in their own homes. The success of these policies depends on appropriately targeting home care services to those most in need, through suitable eligibility criteria and adequate public financing. This report first provides a comparative overview of care allowance systems (cash benefits) for older individuals across the 27 EU countries as of 2024, drawing primarily on MISSOC data supplemented by official sources and expert validation. It then conducts an empirical analysis of formal and informal home care use based on SHARE data (Wave 9), examining cross-country and within-country variation in utilization relative to needs, measured through limitations in activities of daily living (ADLs). The analysis further estimates the share of the population likely to be eligible and gauges the generosity of each national system by applying its rules to the entire European population. The findings reveal substantial heterogeneity: differences in formal care use are driven not primarily by underlying needs, but by the design of eligibility systems, public financing, and cultural and socio-economic factors. Formal and informal care often act as complements rather than substitutes. The report underscores the importance of designing systems that address a continuum of care needs and of continuous monitoring to support more equitable and sustainable long-term care provision across the EU.
Wouterse et al. (Mon,) studied this question.