More and more people reach an age where they have to live with declining functional and cognitive abilities and thus become dependent on the help of others in their daily life. Protecting the right to a life in dignity of frail older people is thus becoming a major policy challenge.

With the ageing populations and growing costs, ensuring and improving the quality of long-term care (LTC) services has become an important policy priority across OECD countries. The share of those aged 80 years and over is expected to increase from 4% in 2010 to nearly 10% in 2050, while in 2010 OECD countries allocated 1.6% of GDP to public spending on LTC, on average. The goal of good quality care is to maintain or, when feasible, to improve the functional and health outcomes of frail elderly, the chronically ill and the physically disabled, whether they receive care in nursing homes, assisted living facilities, community-based or home care settings. This report focuses on three aspects generally accepted as critical to quality care: effectiveness and care safety, patient-centredness and responsiveness and care co-ordination.

There are good reasons why quality assurance for long-term care is on the policy agenda in many OECD countries. First, users of care services demand more voice and control over their lives. Expectations towards the quality of care of “baby boomers” are higher than those of their parents. Most recipients expect to live in a single room to maintain their privacy or expect care services to reflect their own individual needs and preferences. Quality LTC services can help frail and dependent persons being more autonomous and continue to take part in society, despite their conditions. Maintaining independence, autonomy and privacy have been shown to prevent depression and loss of interest in life.