The mixed economy of long-term care in England, Germany, Italy, and Spain

"This paper is based on a European Commission-funded study of future long-term care expenditure in Germany, Italy, Spain and the United Kingdom. It investigates how sensitive long-term care expenditure is to assumptions about demographic trends, future dependency rates, care arrangements, and real inflation. Macro-simulation projection models for each country reflecting the national characteristics of the care system were used to make comparable projections based on a set of common assumptions. This central case was then used as a point of comparison in order to explore the sensitivity of the models to alternative scenarios about key determinants of future expenditure. The proportion of GDP spent on longterm care is projected to more than double between 2000 and 2050 in each country under the central case. However, projections are highly sensitive to changes in the above assumptions." (author's abstract)"Der Beitrag beruht auf einer EU-finanzierten Studie zur zukünftigen Entwicklung der Ausgaben für Langzeitpflege in Deutschland, Italien, Spanien und dem Vereinigten Königreich. Untersucht wird die Sensitivität der Ausgabenentwicklung hinsichtlich unterschiedlicher Annahmen zur demographischen Entwicklung, zur Pflegebedürftigkeit, zur Pflegeform und zu den Kosten der Pflege. Mittels nationaler Makrosimulationsmodelle, die die länderspezifischen Pflegesysteme berücksichtigen, wird ein auf gemeinsamen Annahmen basierendes Grundmodell berechnet, das den Referenzpunkt der nachfolgenden Sensitivitätsanalyse darstellt. Im Ergebnis zeigt sich in allen Untersuchungsländern, dass sich der Anteil des BIP, der für Pflegeleistungen aufgewandt wird, von 2000 bis 2050 mehr als verdoppelt. Allerdings sind diese Ergebnisse sehr sensitiv in bezug auf Veränderungen der genannten Annahmen." (Autorenreferat

Death due to non-traumatic hemoperitoneum in Milan 2002–2016, with focus on two cases of abdominal apoplexy (idiopathic spontaneous hemoperitoneum) and review of the literature

Abdominal apoplexy, also known as idiopathic spontaneous hemoperitoneum, is a rare event related to sudden death, whose diagnosis and treatment is extremely challenging and whose pathologic mechanisms are still mainly unknown. It is frequently associated with vascular disorders (alterations in the vascular structures) and mainly linked to liver cirrhosis. However, the presence of hemoperitoneum may in such cases pose many challenges to forensic post-mortem examinations since the source of bleeding remains often unknown even after a careful and thorough dissection. The Authors present two cases of sudden death related to massive hemoperitoneum (4,650 ml in case 1 and 5,100 ml in case 2) occurred in two cirrhotic males aged 49 and 51: no traumatic injuries were detected and the source of bleeding was not identified although a careful dissection of organs and vascular structures was performed. Rare cases have been already described in the literature, only as case reports, and no systematic studies have been performed on this issue. Nevertheless, this event ought to be taken into account as a cause of sudden death in people with advanced liver disease. A general glimpse is provided among the different causal mechanisms and the challenges within forensic pathology

The mixed economy of long-term care in England, Germany, Italy, and Spain

'This paper is based on a European Commission-funded study of future long-term care expenditure in Germany, Italy, Spain and the United Kingdom. It investigates how sensitive long-term care expenditure is to assumptions about demographic trends, future dependency rates, care arrangements, and real inflation. Macro-simulation projection models for each country reflecting the national characteristics of the care system were used to make comparable projections based on a set of common assumptions. This central case was then used as a point of comparison in order to explore the sensitivity of the models to alternative scenarios about key determinants of future expenditure. The proportion of GDP spent on longterm care is projected to more than double between 2000 and 2050 in each country under the central case. However, projections are highly sensitive to changes in the above assumptions.' (author's abstract)'Der Beitrag beruht auf einer EU-finanzierten Studie zur zukuenftigen Entwicklung der Ausgaben fuer Langzeitpflege in Deutschland, Italien, Spanien und dem Vereinigten Koenigreich. Untersucht wird die Sensitivitaet der Ausgabenentwicklung hinsichtlich unterschiedlicher Annahmen zur demographischen Entwicklung, zur Pflegebeduerftigkeit, zur Pflegeform und zu den Kosten der Pflege. Mittels nationaler Makrosimulationsmodelle, die die laenderspezifischen Pflegesysteme beruecksichtigen, wird ein auf gemeinsamen Annahmen basierendes Grundmodell berechnet, das den Referenzpunkt der nachfolgenden Sensitivitaetsanalyse darstellt. Im Ergebnis zeigt sich in allen Untersuchungslaendern, dass sich der Anteil des BIP, der fuer Pflegeleistungen aufgewandt wird, von 2000 bis 2050 mehr als verdoppelt. Allerdings sind diese Ergebnisse sehr sensitiv in bezug auf Veraenderungen der genannten Annahmen.' (Autorenreferat)German title: Die gemischte Wirtschaft der Langzeitpflege in England, Deutschland, Italien und SpanienAvailable from Universitaet Bremen, Zentrum fuer Sozialpolitik, Bremen (DE) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman