Peter Willemé

Relation of scores on Rotter's I-E scale to short-term and long-term control expectancies and fatalism.

The purpose of the present research was twofold. First, we analysed whether expectancies of personal control versus nonpersonal control could reliably be assessed by structured interviews recorded on videotape. Second, by means of factor analysis, we analysed the relation between the interview locus-of-control scores and the scores obtained by Rotters I-E scale. Analysis showed that the scores on Rotters I-E scale are correlated with short-term expectancies but not with long-term expectancies or fatalism. Possible explanations for these findings are suggested.

Long-term care use and socio-economic status in Belgium: a survival analysis using health care insurance data

BackgroundThe small but growing literature on socio-economic inequality in morbidity among older persons suggests that social inequalities in health persist into old age. A largely separate body of literature looks at the predictors of long-term care use, in particular of institutional care. Various measures of socio-economic status are often included as control variables in these studies. Review articles generally conclude that the evidence for such variables being a predictor for institutionalization is “inconclusive”. In this paper we look at the association among older persons in Belgium between one particular measure of socio-economic status – preferential status in public health care insurance – and first use of home long-term care and residential care. Preferential status entitles persons to higher reimbursement rates for health care from the public health care insurance system and is conditional on low income. We also study whether preferential status is related to the onset of five important chronic conditions and the time of death.MethodsWe use survival analysis; the source of the data is a large administrative panel of a sample representative for all older persons in Belgium (1,268,740 quarterly observations for 69,562 individuals).ResultsWe find a strong association between preferential status and the likelihood of home care use, but for residential care it is small for men and non-existent for women. We also find that preferential status is significantly related to the chance of getting two out five chronic conditions – COPD and diabetes, but not dementia, hip fracture and Parkinson’s disease – and to the probability of dying (not for women). For home care use and death, the association with preferential status declines with increasing age from age 65 onwards, such that it is near zero for those aged around 90 and older.ConclusionWe find clear associations between an indicator of low income and home care use, some chronic conditions and death. The associations are stronger among men than among women. We also find that the association declines with age for home care use and death, which might be explained by selective survival.

The Long-Term Care System for the Elderly in Belgium

Launched in January 2009, ANCIEN is a research project that runs for a 44-month period and involves 20 partners from EU member states. The project principally concerns the future of long-term care (LTC) for the elderly in Europe and addresses two questions in particular: 1) How will need, demand, supply and use of LTC develop? 2) How do different systems of LTC perform? This case study on Belgium is part of the first stage in the project aimed at collecting the basic data and necessary information to portray long-term care in each country of the EU. It will be followed by analysis and projections of future scenarios on long-term care needs, use, quality assurance and system performance. State-of-the-art demographic, epidemiologic and econometric modelling will be used to interpret and project needs, supply and use of long-term care over future time periods for different LTC systems.

Long-Term Care Financing in Belgium

Long-term care (LTC) in Belgium consists of a wide range of benefits in cash and in kind, organized at the federal, regional and municipal levels, and is related to health and social service provision.1 The bulk of LTC services are provided as part of the federal public compulsory health insurance system, which is financed by social security contributions and general taxes. The main actors in the management of the system are the federal parliament (issuing the main laws governing the system), the Ministries of Health and Social Affairs, the National Institute for Health and Disability Insurance (NIHDI) and the sickness funds, which serve as intermediaries between the administration, the providers and the patients. Since public health insurance covers practically the whole population, LTC coverage is also nearly universal. However, since LTC services provided through the health insurance system cover only nursing care (as well as paramedical and rehabilitation care) and part of personal care to dependent persons, a whole range of services is organized and provided at the regional and local level. Indeed, while there is no specific LTC legislation at the federal level, the regional governments have issued decrees that regulate a wide range of issues related to LTC services: certification of facilities such as nursing homes and day care centres, integration and coordination of services at the local level, quality monitoring systems and so on.

A statistical approach to conservation supply curves

While conservation supply curves (CSCs) have been used extensively to estimate the potential of energy conservation, it is recognised that the assumptions of single point unit costs, sequential introduction of measures and (sometimes) lack of interaction effects are major drawbacks. In this article an attempt is made to alleviate some of these problems, while retaining a relatively simple model and without requiring prohibitive amounts of additional data. The idea of a range of unit costs of a conservation measure is operationalized with a logistic curve, which shows the fraction of the total conservation potential that can be economically saved at any energy price. Different measures can be introduced at overlapping ranges of unit costs, avoiding the problem of sequential ordering of the measures in traditional CSCs. When the maximum conservation potential of a measure is allowed to decrease linearly with the introduction of other measures, the model can be extended to allow for negative interaction effects between measures. The model has been applied to estimate the economically achievable energy saving potential for Flemish residential heating.

How European Nations Care for Their Elderly: A New Typology of Long-Term Care Systems

Table of Contents: Introduction; Evidence and analysis; Policy implications and recommendations; Research parameters;

Wage Inequality and Immigration: Western-Europe in the Sixties

We analyse the immigration flows to Western Europe in the sixties. We develop a theoretical model tailored to account for some of the key features of this period, i.e., trade in manufacturing that essentially involved advanced countries, the growing administration of labour markets in Western Europe and the huge inflow of low skilled immigrants from the South (less advanced countries) into Western Europe. Two propositions are subsequently derived from this model. First, the immigration flow increases with the skill premium in the country of destination. Second, for a given skill premium, immigration is an increasing function of both the host country’s working population and its relative endowment in skilled labour. The first proposition reflects a demand side effect that diverges from the result of the traditional self-selecting approach to migration, i.e., that a higher skill premium in the country of destination tends to discourage potential low-skilled migrants. Estimations implemented for a panel of four European countries (Belgium, France, Sweden and West Germany) over the period 1960-1975 corroborate to a large extent our propositions. We also find that none of the supply determinants are individually significant at equilibrium. These results confirm the hypothesis that immigration to Western Europe in the sixties was primarily demand driven.