Across OECD countries, long-term care (LTC) systems are under pressure to adapt. The demand for services for older people will very likely increase, raising concerns over financial sustainability. As a labour-intensive sector, the productivity and sustainability of LTC services highly depends on an effective and efficient workforce. Achieving the latter is an important challenge, especially since the beginning of the COVID-19 pandemic. The OECD examines challenges and policy options for strengthening the LTC workforce, including on training, recruitment and retention, productivity and use of technology, coordination between social and health workers, and coordination between formal and informal workers.

Key insights

The number, competency and type of professionals providing LTC services varies greatly across countries, and so do their policies. For instance:

• In several countries LTC workers do not receive a specific education or training to work in this sector
• While in some countries the stock of LTC workers is extremely low and LTC spending has been cut in recent years, in others the situation is considerably less alarming
• Low pay, high turnover and part-time work remain key features of many LTC labour markets, and working in this sector is still not attractive
• Several countries still rely on informal workers – such as families and friends – to provide LTC services
• Evidence on productivity improvements in LTC labour markets continue to be sparse, despite attempts to introduce ICT, reorganise work processes and delegation of tasks to lower cadres
• Coordination across health and LTC settings remains an important challenge in ensuring quality and continuity of care services

Low numbers of carers relative to the population aged 65+ persist in most countries
Rate of LTC workers per 100 elderly, 2019 and 2011 (or nearest year)

Notes: 1. Break in time series. 2. Data for Sweden cover only the public providers. In 2016, 20% of beds in LTC for the elderly were provided by private companies (but publicly financed).
Access the data.
The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law.
Source: OECD Health Statistics 2021, complemented with EU-LFS.

Documents and resources

• Providing long-term care: Options for a better workforce. In International Social Security Review, Special Issue: The human right to long-term care for the elderly: Extending the role of social security programmes. Volume 75, Issue 3-4, July-December 2022.
• Rising from the COVID 19 crisis: Policy responses in the long-term care sector, Brief (December 2021)
• Key Insights & Proposed Solutions From the Future of Care and the Caregiving Workforce: Lessons and Insights from the COVID-19 Experience, An Expert Workshop co-Hosted by the OECD, the Global Coalition on Aging and Home Instead (21 October 2021)
• COVID-19 in long-term care, OECD Health Working Paper No. 131 (October 2021)
• Spending on Long-term Care, Brief (November 2020)
• Who Cares? Attracting and Retaining Care Workers for the Elderly (June 2020)
• The effectiveness of social protection for long-term care in old age, OECD Health Working Paper No. 117 (April 2020)
• A Good Life in Old Age? Monitoring and Improving Quality in Long-term Care (June 2013)
• Help Wanted? Providing and Paying for Long-Term Care (May 2011)

 

Further reading

• Health at a Glance 2023 - OECD Indicators: read the special chapter on Ageing and long-term care (November 2023)
• Care Needed: Improving the Lives of People with Dementia (June 2018)
• Preventing Ageing Unequally (October 2017)
• The Pursuit of Gender Equality: An Uphill Battle (October 2017)

 

Contact us

• Ms Ana Llena-Nozal: ana.llena-nozal@oecd.org

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