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Context

The research project ‘Changes in the provision of care for loss of independence and the choices made by older people’ aims to examine the role of the provision of care for loss of independence in the choices made by older people regarding care arrangements.

The ageing population is a concern for public policy-makers. The number of people requiring assistance is expected to rise over the coming years. Conversely, there are pressures on the supply of care services. It is observed that the number of beds in care homes has grown slowly, as has the number of services offering home care for older people, partly due to the low attractiveness of careers in long-term care. Conversely, the use of care homes or professional care has increased only slightly. To date, it has not been clearly established whether this minimal change in the use of such services is linked to an insufficient, unsuitable or even overly expensive supply, to a change in the care needs of older people, or to a shift in their preferences.

Presentation

This project comprises two strands.

The first strand is descriptive. Its aim is to quantify and describe in detail:

  • the provision of care for loss of independence in France,
  • the uptake of care services,
  • and the needs of older people.

The provision will be assessed in terms of the facilities and professionals who support older people in their own homes or in care homes with activities of daily living. Particular emphasis will be placed on distinguishing between the location of care (at home or in a care home) and the type of organisation, broken down to a detailed geographical level (at least the department) and for at least two dates, in order to assess how the situation has changed. The aim will also be to gather data on the pricing of these services.

In the second research strand, the aim will be to unpick the reasons for the slow growth in the use of these services by analysing the concurrent evolution of needs, the structure of the provision and the level of uptake. Researchers will analyse trends in care provision using decomposition methods (Oaxaca-Blinder and Yun) to distinguish between changes driven by evolving needs and those driven by changes in supply, in particular by analysing departmental variations in the relationships between needs, uptake and supply.

Research Team

This project is led by the pole Health and autonomy.
Amélie Carrère
Amélie Carrère
Delphine Roy
Delphine Roy

Method and Data

The researchers will draw on data from the Drees (Finess, EHPA and SAE), data from the DGE (NOVA), data from the CNAMTS (Amos and PMSI-HAD) and data from Acoss-Urssaf and CnCesu. These data cover the following services: employees of private employers, home help and care services (SAAD), home nursing services (SSIAD), multi-purpose home help and care services (SPASAD), home hospitalisation services (HAD), private practising nurses, residential care homes for dependent elderly people (EHPAD), residential care homes for older people (EHPA) other than EHPADs, long-term care units (USLD), independent living homes, day centres and temporary accommodation. The needs of older people will be assessed on the basis of their limitations in carrying out activities of daily living, using several surveys: Daily Life and Health (VQS) 2007 and 2014; Residential Care Homes for Older People (EHPA) 2007 and 2015; Disability and Health in Households (HSM) 2008; Disability and Health in Care Homes (HSI) 2009; Capacities, Support and Resources of Older People (CARE) – Households 2015 and CARE – Care Homes 2016.

Partners

Institut pour la Recherche en Santé Publique

This research programme is funded by the Institute for Public Health Research (IReSP) through the 2021 call for proposals entitled ‘Facilities, services and changes to the medical and social care provision (session 3)’.

Last modified: July 20, 2026