Beyond Applause? Improving Working Conditions in Long-Term Care

Beyond Applause? Improving Working Conditions in Long-Term Care

This report presents an in-depth cross-country analysis of how long-term care workers fare along the different dimensions of job quality. In the initial stages of the COVID-19 pandemic, the applause for care workers was a clear expression of the strong recognition of their hard work and exposure to...

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Detalles Bibliográficos
Autor principal: Organisation for Economic Co-operation and Development (author)
Autor Corporativo: Organisation for Economic Co-operation and Development, author (author)
Formato: Libro electrónico
Idioma:Inglés
Publicado: Paris : OECD Publishing 2023.
Edición:1st ed
Materias:
Employment.
Ver en Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009754406606719
Tabla de Contenidos:
  • Intro
  • Foreword
  • Editorial
  • Table of contents
  • Executive summary
  • LTC labour shortages may reach socially unacceptable levels if no decisive action is taken now
  • Tough working conditions diminish care quality and dissuade potential workers
  • Policy implications
  • Key facts and figures (Infographic)
  • 1 Beyond Applause? Improving working conditions in long-term care: An overview
  • Beyond applause: Better working conditions are key to meeting increasing long-term care needs
  • 1.1. Labour shortages may reach unacceptable levels in the near future if no decisive action is taken now
  • 1.1.1. One-quarter of people with severe limitations in activities of daily living receive neither formal nor family care
  • 1.1.2. Many countries have been struggling to recruit LTC workers
  • 1.1.3. Demand for LTC workers as a share of total employment is projected to increase by 32% over the forthcoming decade
  • 1.1.4. Labour shortages will grow substantially even with large efficiency gains
  • 1.2. Tough working conditions affect care quality and dissuade potential workers
  • 1.2.1. High physical and mental health risks and difficult working hours
  • 1.2.2. Low wages, especially for personal care workers
  • 1.2.3. Lack of recognition of LTC workers and of the skills and competences required
  • 1.3. Why wages are low and working conditions do not improve despite shortages
  • 1.3.1. Factors contributing to low wages in the LTC sector
  • 1.3.2. Low wages despite persistent shortages
  • Low labour market power of LTC workers
  • Mismatches
  • Insufficient financing
  • 1.4. Policy implications
  • 1.4.1. More public financing and leading role by governments to improve working conditions
  • 1.4.2. Direct interventions: increasing wages and strengthening staff requirements
  • 1.4.3. Supporting collective bargaining and social dialogue.
  • 1.4.4. Improving training to reduce arduous work and enhance the quality of care
  • 1.4.5. Promoting the social recognition of long-term care workers
  • 1.4.6. Improving efficiency and reducing arduous work through introducing new technologies
  • 1.4.7. Strengthening preventive health policies to reduce long-term care needs
  • References
  • Annex 1.A. Definitions
  • Long-term care
  • Formal care: Nurses and personal care workers
  • Informal care
  • Declared and undeclared work
  • Long-term care settings
  • Notes
  • 2 Work and wages in long-term care today
  • Introduction
  • Key findings
  • 2.1. What is long-term care work?
  • 2.1.1. What do long-term care workers do?
  • Personal care workers
  • Nurses
  • 2.1.2. How to become an LTC worker?
  • Educational levels and qualification requirements
  • Abilities and skills needed by personal care workers
  • Competency requirements and future challenges
  • 2.1.3. How many workers work at LTC jobs?
  • 2.1.4. Is home-based care expanding faster than residential care?
  • 2.2. Wages of LTC workers
  • 2.2.1. How do wages of LTC workers compare to those of other workers?
  • Workers in residential and non-residential care sectors earn on average 80% of economy-wide average wage
  • Personal care workers earn about 70% of the economy-wide average wage
  • Nurses earn substantially more than personal care workers
  • Wages of personal care workers in residential and non-residential care sectors have kept pace with the average
  • 2.2.2. What drives wages of LTC workers?
  • PIAAC data allows for a novel wage analysis of LTC workers
  • Half of wage differences between personal care workers and nurses relates to differences in education and other personal characteristics
  • The LTC sector pays significantly less than the hospital sector to similar workers.
  • Gender differences in hourly wages are lower for LTC workers than on average for other workers
  • Regression results do not provide evidence of pay discrimination against foreign-born LTC workers
  • Higher wages for those with health-related education, working in larger companies and in the public sector
  • 2.2.3. Why do LTC jobs pay low wages despite labour shortages?
  • Low wages and labour shortages
  • Amenities and unobserved characteristics of workers
  • Devaluation of women's work
  • Entry barriers
  • Financing constraints, rent sharing and labour market power
  • References
  • Notes
  • 3 Work environment and collective bargaining in long-term care
  • Introduction
  • Key findings
  • Work environment
  • Collective bargaining
  • 3.1. Tenure and labour market security of long-term care workers
  • 3.1.1. Tenure and retention
  • 3.1.2. Labour market security
  • 3.2. Quality of the working environment in long-term care
  • 3.2.1. Arduousness of LTC work
  • Absence from work
  • Physicality of LTC work
  • Psychological impact of LTC work
  • 3.2.2. Working-time arrangements
  • Night and weekend work
  • Part-time work
  • 3.2.3. Opportunities for adult learning
  • 3.2.4. Enforcement of labour regulations
  • 3.3. A portrait of collective bargaining in the long-term care sector
  • 3.3.1. Unionisation and bargaining coverage among long-term care workers tend to mirror national patterns
  • 3.3.2. Good practices exist within heterogenous OECD collective bargaining systems
  • References
  • Notes
  • 4 Social recognition, gender- and migration-related issues in long-term care
  • Introduction
  • Key findings
  • Social recognition
  • Gender
  • Migration
  • 4.1. Social recognition of long-term care work
  • 4.1.1. Social recognition of LTC work by different actors and the variety of forms it takes
  • How different actors value LTC work.
  • Social recognition can take various forms
  • 4.1.2. Undervaluation of LTC work
  • What is social value?
  • Gender norms: care as "women's nature"
  • Care for money or for love?
  • 4.1.3. Measures taken to boost social recognition of LTC workers
  • Increasing remuneration of LTC workers
  • Education and training
  • Campaigns to improve the public image of LTC workers
  • 4.2. Gender issues in the long-term care sector
  • 4.2.1. Are gender gaps in employment and wages wider in the LTC sector?
  • Employment
  • Earnings
  • 4.2.2. Why are most LTC workers women?
  • 4.2.3. Recruiting more men to improve the gender balance in the LTC sector
  • 4.3. Role of migrants in the long-term care sector
  • 4.3.1. How migrants are filling employment gaps in long-term care
  • Share of foreign-born workers
  • Legal channels for recruitment and recruitment campaigns
  • 4.3.2. Are migrant LTC workers treated fairly?
  • Many migrant workers provide live-in care for which labour regulations are harder to enforce
  • Comparison of earnings and qualifications
  • References
  • Notes
  • 5 Looking ahead: Current and future labour shortfalls in long-term care
  • Introduction
  • Key findings
  • Shortages of LTC workers
  • New technologies
  • 5.1. Evidence on current unmet needs and staff shortages in long-term care
  • 5.1.1. Many older people experience unmet long-term care needs
  • 5.1.2. Shortages of LTC workers are structural and intensified during COVID-19 crisis
  • Identifying staff shortages is challenging
  • Many countries report shortages of LTC workers
  • With COVID-19, job offers for LTC workers increased substantially in 2020
  • 5.2. Recent measures taken to address LTC staff shortages
  • 5.3. Key drivers of higher labour demand for LTC workers over time
  • 5.3.1. Several factors generate shortages of LTC workers.
  • 5.3.2. Ageing boosts LTC needs and inhibits their fulfilment
  • 5.3.3. Extent of healthy ageing and demographic effects on labour demand in LTC
  • 5.3.4. Income and productivity growth effects on the demand for LTC workers
  • 5.4. How new technologies may limit labour shortages in long-term care
  • 5.4.1. New technologies are available to help workers in most LTC tasks
  • 5.4.2. The use of new technologies in LTC is limited, but some are promising
  • Low IT-related investments in the LTC sector
  • Most new technologies used in the LTC sector are inexpensive and easy to implement
  • Robotic technology could be used for a variety of tasks in LTC
  • 5.4.3. New technologies may help limit the demand for LTC workers in the future
  • New technologies may reduce demand for LTC workers and improve working conditions
  • New technologies may facilitate independent living of older people
  • 5.4.4. Needed skills to successfully implement new technologies
  • Acquiring standard digital skills is the first step
  • Boosting older people's digital skills to improve use of new technologies
  • Annex 5.A. Projections of the number of people in selected age groups
  • Annex 5.B. Longevity and disability-free years of life
  • References
  • Notes.

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