Nội dung

Special Eurobarometer European Commission Health and long-term care in the European Union Fieldwork: May – June 2007 Publication: December 2007 Special Eurobarometer 283/ Wave 67.3 – TNS Opinion & Social Report This survey was requested by Directorate-General for Employment, Social Affairs and Equal Opportunities and coordinated by Directorate-General for Communication. This document does not represent the point of view of the European Commission. The interpretations and opinions contained in it are solely those of the authors. Special EUROBAROMETER 283 “Health and Long-Term Care” Table of contents INTRODUCTION..................................................................................3 1. THE HEALTH OF EUROPEANS .......................................................5 1.1 Healthy living .......................................................................5 1.2 The consequences of unhealthy behaviour and situations ..11 1.3 Health limitations ...............................................................14 1.4 Becoming dependent upon the help of others.....................17 1.5 Preparations for the future .................................................22 2. HEALTH CARE IN EUROPE..........................................................25 2.1 Hospitals ............................................................................25 2.2 Dental care .........................................................................33 2.3 Medical or surgical specialists ............................................42 2.4 Family doctors ....................................................................48 2.5 Care services for dependent people ....................................54 2.6 Nursing homes ...................................................................60 3. ATTITUDES TO CARE OF ELDERLY AND DEPENDENT PEOPLE .....66 3.1 Best care option for elderly parents....................................66 3.2 Attitudes regarding care for the elderly..............................68 3.3 Attitudes concerning the situation of dependent elderly people……… .....................................................................................72 -1- Special EUROBAROMETER 283 4. “Health and Long-Term Care” PROVIDING LONG-TERM CARE ..................................................78 4.1 Experience with long-term health care ...............................78 4.2 Paying for the long-term care of a parent...........................85 5. RECEIVING LONG-TERM CARE ...................................................91 5.1 Likelihood of receiving appropriate care in the future ........91 5.2 Expected and preferred form of long-term care..................95 5.3 Financing long-term care..................................................100 6. MALTREATMENT OF DEPENDENT ELDERLY PEOPLE..................107 6.1 Occurrence of poor treatment, neglect and abuse ............107 6.2 Forms of maltreatment faced by dependent elderly people109 6.3 Perceived ‘offenders’ ........................................................112 6.4 Preventing maltreatment..................................................114 CONCLUSION..................................................................................117 ANNEXES Respondents’ sociodemographic profile Technical note Questionnaire Data tables -2- Special EUROBAROMETER 283 “Health and Long-Term Care” INTRODUCTION Confronted with rising long-term care needs due to an increasingly ageing population, the European Union is supporting the Member States in their efforts to improve health and long-term care in Europe. In 2002, the Barcelona European Council recognised three guiding principles for the reform of health care systems: accessibility for all, high quality care and long-term financial sustainability. It is in this context that the Directorate-General Employment of the European Commission commissioned a survey that examines public opinion about health care across Europe, focussing specifically on long-term care and care of the elderly. Between the 25th of May and the 30th of June 2007, TNS Opinion & Social interviewed 28,660 Europeans aged 15 and over living in the 27 European Union Member States and the two candidate countries (Croatia and Turkey). The methodology used is that of the Standard Eurobarometer surveys of the Directorate-General Communication (“Public Opinion and Media Monitoring” Unit). A technical note concerning the interviews, carried out by the institutes of the TNS Opinion & Social network, is annexed to this report. This note specifies the interview method used, as well as the confidence intervals1. This report studies successively the following issues covered by the survey. ♦ First of all, we focus on the lifestyle of Europeans, their health-limitations and their views about becoming dependent upon the help of others. In chapter two we examine the public’s assessment of the health-care system in general and the care of dependent people specifically by looking at quality, availability, accessibility and affordability of health care services. We furthermore analyse the extent to which people have had to do without care because of availability, accessibility or affordability problems. ♦ The second part of the report focuses on attitudes to care of elderly and dependent people: how people want their elderly parents to be looked after, how should the care of elderly and dependent people be financed and how well elderly and dependent people are perceived to be looked after. ♦ In the final part we focus specifically on long-term care and the care of the elderly. We firstly examine Europeans’ views about the provision of long term care: the appropriateness and costs and to what extent they themselves have been involved in providing care. We then look at people’s views about receiving care: the perceived likelihood that people will receive appropriate care in the future, how they expect and prefer to be taken care of should the need arise and how they think they will finance their future long-term care. In the last chapter, we look at the extent to which abuse of elderly dependent people is perceived to be taking place, what forms of abuse this vulnerable group is subjected to and who the perpetrators are perceived to be. 1 The results tables are included in the annex. The totals indicated may show a one point difference with the sum of the individual units. It should also be noted that the total of the percentages in the tables of this report may exceed 100% when the respondent has the possibility to give several answers to the same question. -3- Special EUROBAROMETER 283 “Health and Long-Term Care” In this report the countries are represented by their official abbreviations. Other abbreviations used in this report are: ABBREVIATIONS EU27 EU15 NMS12 European Union - 27 Member States European Union - 15 Member States prior to 1st May 2004 New Member States – 12 Member States which joined the EU after 1st May 2004 DK Don’t know BE BG CZ DK D-E DE D-W EE EL ES FR IE IT CY LT LV LU HU MT NL AT PL PT RO SI SK FI SE UK Belgium Bulgaria Czech Republic Denmark East Germany Germany West Germany Estonia Greece Spain France Ireland Italy Republic of Cyprus Lithuania Latvia Luxembourg Hungary Malta The Netherlands Austria Poland Portugal Romania Slovenia Slovakia Finland Sweden The United Kingdom HR TR Croatia Turkey TEA: Terminal Education Age, meaning age at which the respondent left full-time education Readers are reminded that survey results are estimations, the accuracy of which rests upon the sample size and upon the observed percentages. -4- Special EUROBAROMETER 283 1. “Health and Long-Term Care” THE HEALTH OF EUROPEANS We begin this report with an examination of the state of health of Europeans living in the European Union, Croatia and Turkey. We will look at both healthy and unhealthy living habits as well as the extent and nature of the limitations people face because of their health and their self-perceived life expectancy. At the end of this chapter, we look at the extent to which people believe they may become dependent on others because of their health and how they feel about this. The results will be analysed on the basis of respondents’ age, sex, gender, education and occupational status and by their country of residence. 1.1 Healthy living Looking at the lifestyle of European Union citizens, the survey shows that, on average, three out of ten Europeans seem to lead a healthy life. These are people who are not affected by any of the nine “health vices and hazards” listed in the graph below2. QA24 Could you please tell me if any of the following apply to you? (MULTIPLE ANSWERS POSSIBLE) - % EU27 You smoke 30% You never do any exercise, or do so very rarely 24% You are overweight 20% You suffer from stress at work 17% You do not eat very healthy food 14% You suffer from stress in your personal relations 10% You live in a noisy environment 8% You tend to drink a bit too much alcohol You live or work in an environment that is heavily polluted 7% 6% None of the above (SPONTANEOUS) DK 32% 1% Smoking remains the biggest vice and 30% of Europeans smoke. Weight related problems are also widespread: 24% of respondents say they never or very rarely exercise, 20% say they are overweight and 14% say they do not eat very healthy food. Then there is stress: 17% of Europeans suffer stress at work and 10% suffer from it in their personal relations. 2 QA24 Could you please tell me if any of the following apply to you? (MULTIPLE ANSWERS POSSIBLE) -5- Special EUROBAROMETER 283 “Health and Long-Term Care” However these European averages conceal large variations depending on people’s demographic characteristics and their country of residence. Firstly, when it comes to differences based on gender, age, education3 and occupational status, the most relevant variations to report are as follows4: • • • • Gender: men are more likely to report that they smoke and experience stress from work while women are more likely to report that they are overweight and do not exercise. On the whole, however, women abstain from unhealthy behaviour more so than men (34% vs. 29%); Age: people aged 55 and over are considerably less likely than the average to report that they smoke. Being overweight and lacking exercise affects people aged 40 and over the most. Unhealthy eating habits are most widespread among the youngest respondents. Overall, respondents aged 55 and over tend to have the healthiest lifestyles (39% refrain from unhealthy behaviour); Education: Students report the healthiest behaviour as they are the least likely to be affected by the nine “vices and hazards” (43%); Occupational status: More than a half of unemployed Europeans report that they smoke (53%). This group of Europeans also more frequently reports suffering from stress in their personal relations (19%) and is most likely to live in a noisy environment (12%). These findings suggest that being unemployed presents a health-risk. High levels of stress at work are reported by managers (39%) while retired people most often report being overweight (27%). Overall, however, retired Europeans report a healthier life-style than average (41% abstain from any unhealthy behaviour). QA24 Could you please tell me if any of the following apply to you? (MULTIPLE ANSWERS POSSIBLE) You smoke EU27 30% Sex Male 35% Female 24% Age 15-24 34% 25-39 39% 40-54 34% 55 + 17% Education (End of) 15 25% 16-19 36% 20+ 28% Still Studying 25% Respondent occupation scale 37% Self- employed 21% Managers Other white collars 33% Manual workers 42% House persons 23% Unemployed 53% Retired 18% Students 25% You are overweight You never You do not do any eat very exercise, healthy or do so food very rarely You tend to drink a bit too much alcohol You live in a noisy environment You You live or You suffer suffer from stress None of work in an from environment the above in your that is heavily stress at personal (SPONT.) polluted relations work DK 20% 24% 14% 7% 8% 6% 17% 10% 32% 1% 19% 22% 22% 25% 16% 12% 12% 3% 8% 7% 7% 5% 19% 15% 7% 13% 29% 34% 1% 1% 9% 15% 25% 26% 17% 23% 26% 26% 22% 16% 14% 8% 10% 8% 9% 4% 10% 9% 8% 6% 6% 7% 8% 3% 11% 25% 26% 5% 11% 11% 12% 7% 37% 26% 25% 39% 1% 1% 1% 1% 23% 22% 20% 8% 27% 25% 23% 15% 10% 16% 12% 20% 6% 8% 8% 9% 6% 8% 8% 11% 4% 7% 6% 5% 8% 18% 28% 8% 9% 10% 10% 11% 36% 28% 29% 43% 1% 1% 1% 1% 18% 19% 21% 19% 20% 24% 27% 8% 22% 20% 27% 23% 28% 26% 26% 15% 13% 12% 17% 17% 9% 19% 8% 20% 10% 10% 8% 9% 2% 12% 5% 9% 8% 6% 7% 9% 7% 12% 5% 11% 8% 5% 7% 10% 3% 6% 3% 5% 28% 39% 29% 27% 2% 5% 1% 8% 10% 8% 9% 9% 14% 19% 8% 11% 27% 30% 26% 24% 36% 22% 41% 43% 1% 1% 1% 1% 2% 1% 1% 1% 4 In the table, groups that deviate by 3 percentage points or more from other groups in their category are highlighted in red (= less healthy) or green (= healthier). -6- Special EUROBAROMETER 283 “Health and Long-Term Care” The European Union average also conceals large variations between Member States in the extent to which respondents report unhealthy behaviour. If we take the top three reported bad habits firstly we find that smoking is most widespread in Greece (44%) and Latvia (41%) and least widespread in Sweden (19%). Yet, despite these extremes, in most surveyed nations the reported smoking rates range from between a quarter to a third of respondents. -7- Special EUROBAROMETER 283 “Health and Long-Term Care” When it comes to exercise, the country by country variation is greater. In Lithuania, more than a half of respondents report that they never or very rarely exercise (51%). Similarly high levels report the same in Turkey (48%). At the other extreme, we find that in Germany only 14% of people report that they never or only very rarely exercise, followed by Ireland and Finland (both 15%). -8- Special EUROBAROMETER 283 “Health and Long-Term Care” While on average one European in five say they are overweight, in Malta this applies to over a third of people (34%). After Malta, Sweden (29%) and the United Kingdom (28%) have the highest proportions of respondents who report that they are overweight. Conversely, very few people in Romania (11%), Bulgaria (13%) and Ireland (14%) report being overweight. The table on the next page shows the country results for each of the nine health vices and hazards. For each, the country with the lowest reporting percentage is highlighted in green and the country with the highest is highlighted in red. -9-