Eligibility for long-term care in The Netherlands: development of a decision support system

In The Netherlands, eligibility for subsidised long-term care services is assessed by regional governmental assessment agencies. We examined which factors predict eligibility for eight long-term care alternatives, ranging from a variety of arrangements for care at home to admissions to residential and nursing homes. Data were drawn from the records of a sample of the regional assessment agencies, mostly during the year 2000. The model shows that not only disease and disability but also age, household composition, current housing situation, and use of health-care services determine the choice between the long-term care alternatives. On the basis of this model, we developed a decision support system. This system predicts eligibility for long-term care alternatives on the basis of applicant characteristics, and can support needs assessors in making decisions on the eligibility of individual applicants. It is used for standardization of intake processes and development of protocols for needs assessors. At the population level, it may provide information for managers and policy-makers on the distribution of demand for long-term care in the near future.