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Demand for Long-Term Care for Older People in England to 2031

By Raphael Wittenberg, Linda Pickard, Adelina Comas-Herrera, Bleddyn P. Davies and Robin Darton


How best to finance long-term care has been the subject of considerable debate in Britain. This article outlines the methodology and results of a model (developed by the Personal Social Services Research Unit) that makes projections of demand for long-term care for older people (aged 65 and older) to 2031. Key findings include: to keep pace with demographic pressures over the next thirty years, residential and nursing home places would nee to expand by around 65 per cent and numbers of hours of home care by around 48 per cent, assuming unchanged dependency rates; long-term care expenditure would need to rise by around 148 per cent in real terms between 1996 and 2031 to meet demographic pressures and allow for real rises in care costs of one per cent per year for social care and 1.5 per cent per year for health care; these projections are highly sensitive to the projected growth in the number of older people, to future dependency rates and to assumed real rises in the unit costs of care. However, they are less sensitive to future household composition. They assume no change in policy and make no allowance for changes in public expectations

Year: 2001
DOI identifier: 10.1057/9780230349193_9
OAI identifier:

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  1. (1994). Accuracy and uncertainty of the national population projections for the United Kingdom.
  2. (2000). Analysis of the GHS elderly data for 1998/9, which shows a shift in the balance between public and private home care, will be incorporated into the model when available. (People aged 65 and over. Office for National Statistics:
  3. (1996). As the GAD marital status projections only extend to 2021, projections to 2031 in the model assume constant rates between 2021 and 2031. 30 Forrest
  4. (1997). Chronic disability trends in elderly United States populations: 1982–1994. doi
  5. (1999). Costs of formal care for frail older people in England: the resource implications study of the MRC cognitive function and ageing study (RIS MRC CFAS). doi
  6. (1998). Demand for long-term care: projections of long-term care finance for elderly people. doi
  7. (1995). Demographic influences on the future of family care. In (eds) Allen I and Perkins E The Future Of Family Care For Older People. doi
  8. (1994). Financing Long-Term Care in Great Britain. doi
  9. (1991). Gender and Later Life: A Sociological Analysis of Resources and Constraints. Sage doi
  10. (1995). Health Expectancy and Its Uses.
  11. (1996). Health. Residential Accommodation Statistics 1996, Statistical Bulletin 1996/25. Department of Health (London:
  12. (1996). Healthy Life Expectancy in England and Wales: Recent Evidence. Discussion Paper 1205. PSSRU (University of Kent:
  13. (2000). Healthy life expectancy in Great Britain, 1980–96, and its use as an indicator in United Kingdom Government strategies.
  14. (2000). Holmans A and Anderson D. Projections of households in England to 2021. Population Trends 99
  15. (1996). House of Commons Health Committee. Long-Term Care Finance: Memorandum of Evidence.
  16. (1988). household composition and receipt of domiciliary services by elderly disabled people. doi
  17. (1990). in collaboration with doi
  18. It should be noted that the assumptions underlying the GAD high and low variants produce a range in life expectancy at birth which is somewhat narrow compared with variants produced by other organisations (Personal correspondence with GAD).
  19. (2000). Looking back to look forward: lessons from four birth cohorts for ageing in the 21st century.
  20. (1996). national population projections for the United Kingdom and its constituent countries. doi
  21. (1999). New estimates and projections of the population cohabiting in England and Wales.
  22. (2000). Office for National Statistics. National population projections:
  23. (1996). Paying for Long Term Care. Institute for Public Policy Research
  24. (1996). population projections by legal marital status for England and Wales. doi
  25. (1995). Population Review: (2) Are we healthier?
  26. (1996). Population Review: (5) The population aged 60 and over. doi
  27. (1999). Promoting the development of a flourishing independent sector alongside good quality public services.
  28. (1999). Royal Commission on Long Term Care of the Elderly. With Respect to Old Age. Cm 4192. TSO doi
  29. (1994). Sharing the Burden: Strategies for Public and Private Long-Term Care Insurance. The Brookings Institution doi
  30. (2000). Shaw C.1998-based national population projections for the United Kingdom and constituent countries. doi
  31. (1996). Survey of Care Homes for Elderly People: Final Report. Discussion Paper 1423/2. PSSRU (University of Kent:
  32. (2000). The assumption of 2.25 per cent per year growth is in line with trends over the last decade and with the forecast used by the Treasury for purposes of public finances (HM Treasury. Building Long-Term Prosperity for All, Pre-Budget Report:
  33. (1996). The decline in age/gender specific dependency rates on which this statement is based is 0.2 per cent per year between
  34. (2000). The Government’s response to the Royal Commission on Long Term Care. Cm 4818-II. TSO (London:
  35. (1962). The prospect of mortality: England and Wales and the United States of America, doi
  36. (1971). Trends in and transitions to institutional residence among older people in England and Wales, doi
  37. (1991). Use of services in old age: data from three surveys of elderly people. doi
  38. (1993). Who are the consistently high users of health and social services? A follow-up study two and a half years later of people aged 85+ at baseline. doi

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