Abstract

The objective of this paper is to show how the use of data about Long Term Care needs allows public actors to reframe LTC interventions, reaching a better match between supply and needs. Through the analysis of the LTC sector in Italy, and in Lombardy specifically, this paper aims at showing how the public sector has settled for a limited coverage of the needs for LTC, often not targeting the real needs of the population, and how limited knowledge of data about care needs may have contributed to the creation of such behaviour. Switching to a more need-oriented system would allow public actors to locate these gaps between supply and needs, and to strategically plan accordingly.

Data, methods: This paper is centred on an in-depth case study based on the Italian LTC sector and, in particular, on the case of the Lombardy Region, the richest and most populous of the country (10 million inhabitants, 11% of which over the age of 65), and also the most advanced one in the field of LTC. Data for the case study were gathered through a mixed method: some evidence on the use of data was extracted through an analysis of the strategic plans for LTC interventions and through the collection of primary data; said evidence was then validated by interviews with key actors; finally, two focus groups were conducted with public managers responsible for the strategic planning of welfare services in the local authorities of Lombardy. Twenty-two public managers, out of the ninety-eight local authorities, took part in the focus groups. The focus groups were instrumental to investigate the reasons behind the limited use of data, and the potential benefits of introducing them in the strategic planning process.

Results: The case study shows that public managers are often unaware of the real needs of the population for LTC, and do not use data about care needs in the strategic planning. Since many needs are not fulfilled by public supply, and a high number of elderly remains uncovered by public interventions, the case study illustrates how the limited knowledge and sharing of data representing elderly needs in the LTC sector may lead to an unfair and timeworn system, where the recipients of care are not necessarily the ones in greatest need. This paper describes, through the evidence from the focus groups, the potential benefits coming from the use of data in strategic planning for LTC, moving from a static historical allocation of resources toward a more need-centric orientation that stimulates fairness and equality.

Policy implications: Sustainability of LTC systems throughout Europe needs new planning models to face uncertainty and lack of resources. The research shows the importance of integrating data about care needs in the process of welfare policy making, acknowledging that this is an untraditional approach for this policy field. The research also provides some realistic examples of using the data already available to public managers of the LTC sector, in order to achieve more sustainable and fair LTC models.

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