ГЛАВНИ ИЗАЗОВИ СИСТЕМА ДУГОТРАЈНЕ НЕГЕ У ЕВРОПСКИМ ДРЖАВАМА
Ključne reči:
дуготрајна нега, неформални неговатељи, финансијска одрживост
Sažetak
У раду се истражују кључни изазови система дуготрајне неге у савременим европским државама - од институционалне фрагментације и непотпуног нормативног оквира, до проблема у доступности, квалитету и свакодневном функционисању услуга на терену. У циљу свеобухватног сагледавања проблема, аутор најпре представља основне карактеристике система дуготрајне неге у Европи – укључујући правни и стратешки оквир, организационе моделе, расподелу ресурса и улогу неформалних неговатеља - као полазиште за идентификацију системских слабости. Истраживање је потом усмерено на критичку анализу правних, институционалних и финансијских ограничења која утичу на доступност, квалитет и одрживост услуга дуготрајне неге. Посебна пажња посвећена је нормативном оквиру дуготрајне неге као социјалног права, положају неформалних неговатеља (са нагласком на родну димензију), условима рада у формалном сектору, као и проблемима фрагментације надлежности и неравномерне расподеле финансијских средстава. Резултати анализе показују да, упркос извесном нормативном напретку на европском нивоу, већина држава и даље води политику дуготрајне неге која је селективна, недовољно координисана и финансијски нестабилна, уз прекомерно ослањање на неплаћени породични рад. Такође, уочена је потреба за јачањем професионализације кадрова и системским унапређењем услова рада. У закључку се истиче неопходност свеобухватне реформе која би обухватила универзализацију права на негу, интеграцију социјалних и здравствених услуга, подршку формалним и неформалним неговатељима, као и развој праведног и фискално одрживог финансијског оквира.
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Sophie Vandepitte et al., Effectiveness of respite care in supporting informal caregivers of persons with dementia: A systematic review. International Journal of Geriatric Psychiatry, 31(12)/2016, 1277–1288.
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World Health Organization, Regional Office for Europe, Country case study on the integrated delivery of long term care: Portugal, World Health Organization, Regional Office for Europe, Copenhagen 2020, 5-6, https://iris.who.int/bitstream/handle/10665/352857/WHO-EURO-2022-5270-45034-64151-eng.pdf?sequence=1, 25. јун 2025.
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Eurofound, Undeclared care work in the EU: Policy approaches to a complex socioeconomic challenge, Publications Office of the European Union, Luxembourg 2025.
European Commission and Economic Policy Committee (EPC), The 2021 Ageing Report: Economic and Budgetary Projections for the EU Member States (2019–2070), Institutional Paper 148, Luxembourg 2021.
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European Commission, Long-term care report: Trends, challenges and opportunities in an ageing society, Publications Office of the European Union, Luxembourg 2021.
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Stanisława Golinowska et al., Long-term Care for the Elderly: Challenges and Policy Options, CASE Network Reports No. 93, Center for Social and Economic Research, Warsaw 2013, 42–44.
The Council of the European Union, Council Recommendation on access to affordable high-quality long-term care, COM (2022) 441 final, OJ C 476, 15. 12. 2022, 1–11.
UN Women, A toolkit on paid and unpaid care work, New York 2022.
Francesco Colombo et al., Help Wanted? Providing and Paying for Long-Term Care, OECD Health Policy Studies, OECD Publishing, Paris 2011.
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Аndrea Cattaneo et al., „The burden of informal family caregiving in Europe, 2000–2050: a microsimulation modelling study”, The Lancet Regional Health - Europe, 2025, https://www.thelancet.com/action/showPdf?pii=S2666-7762%2825%2900087-0, 15. јун 2025.
Аnna Triandafyllidou, Sabrina Marchetti, „Migrant Domestic and Care Workers in Europe: New Patterns of Circulation?“, Journal of Immigrant & Refugee Studies, 11(4)//2013, 339-346.
Аnneli Anttonen, Olli Karsio, „Eldercare Service Redesign in Finland: Deinstitutionalization of Long-Term Care“, Journal of Social Service Research 42(2)/2016, 151-166.
Аugust Österle, “Long-term Care in Central and South-Eastern Europe: Challenges and Perspectives in Addressing a ‘New’ Social Risk”, Social Policy & Administration, 44(4)/2010, 461-480.
Bent Greve, Long term Care for the Elderly in Europe: Development and Prospects, Routledge, London – New York 2017.
Blanche Le Bihan, Claude Martin, „Reforming Long term Care Policy in France: Private–Public Complementarities“, Social Policy & Administration, Special Issue: Long‐term Care in Europe, 44(4)/2010, 392-410.
Весна Стојановић, „Правни оквир економске и социјалне сигурности особа са инвалидитетом“, Право и привреда 4-6/2017, 729-744.
Walter N. Leutz, „Five Laws for Integrating Medical and Social Services: Lessons from the United States and the United Kingdom“, The Milbank Quarterly 77(1)1999, 77–110.
Eileen Rocard, Ana Llena Nozal, „Supporting informal carers of older people: Policies to leave no carer behind“, OECD Health Working Papers No. 140, OECD Publishing, Paris 2022.
Emili Courtin et al., „Mapping support policies for informal carers across the European Union”, Health Policy 118(1)/2014, 84–94.
Estera Wieczorek et al., Assessing Policy Challenges and Strategies Supporting Informal Caregivers in the European Union, Journal of Aging & Social Policy 34(1)/2022, 145-160.
Caroline de la Porte, Philippe Pochet, „Why and how (still) study the Open Method of Coordination (OMC)?“, Journal of European Social Policy 22(3) 2012, 336–349.
Kai Leichsenring, „Developing Integrated Health and Social Care Services for Older Persons in Europe“, International Journal of Integrated Care 4/2004, 1-15.
Katharine Schulmann et al., Social Support and Long-Term Care in EU Care Regimes: Framework Conditions and Initiatives of Social Innovation in an Active Ageing Perspective, European Centre for Social Welfare Policy and Research, Vienna 2014.
Laurel L. Hixon, „The relationship between social and health services in care for older people“, in Long term Care Reforms in OECD Countries (eds. Cristiano Gori, José Luis Fernández, Raphael Wittenberg), Policy Press, Bristol 2016, 247–270.
Љубинка Ковачевић, „Заштита миграната од социјалних ризика у праву Европске уније“, Страни правни живот 1/2011, 151-171.
Martin Karlsson, Tor Iversen, Henning Øien, „Scandinavian Long Term Care Financing”, in Financing Long Term Care in Europe (eds. Joan Costa Font, Christophe Courbage), Palgrave Macmillan, London 2012, 255-276.
Ricardo Rodriges, Manfred Huber, Giovanni Lamura (eds.), Facts and Figures on Healthy Ageing and Long-term Care - Europe and North America, Occasional Reports Series 8, European Centre, Vienna 2012.
Сенад Јашаревић, Социјално право, Правни факултет Универзитета у Новом Саду, Нови Сад 2015.
Sophie Vandepitte et al., Effectiveness of respite care in supporting informal caregivers of persons with dementia: A systematic review. International Journal of Geriatric Psychiatry, 31(12)/2016, 1277–1288.
Ulrike Schneider, Gerdt Sundström, Lennarth Johannson, María A. Tortosa, „Policies to support informal care“, in Long term care reforms in OECD countries: successes and failures (eds. Cristiano Gori, José Luis Fernández, Raphael Wittenberg), Policy Press, Bristol 2016.
Heinz Rothgang, „Social Insurance for Long-Term Care: An Evaluation of the German Model“, Social Policy & Administration 44(4)/2010, 436–460.
Извори права и документи:
Amnesty International, We Just Want Some Rights! Migrant live in care workers in Austria - Migrant care workers denied rights in Austria, Executive Summary, 2021, https://www.amnesty.org/en/documents/eur13/4342/2021/en/-, 20. мај 2025.
World Health Organization Regional Office for Europe, Country case study on the integrated delivery of long term care: Romania, World Health Organization, Regional Office for Europe, Copenhagen 2020, 4, https://iris.who.int/bitstream/handle/10665/352848/WHO-EURO-2022-5261-45025-64131-eng.pdf?sequence=1, 20. јун 2025.
World Health Organization, Regional Office for Europe, Ageing in place – How Sweden provides and pays for universal and integrated long term care, World Health Organization, Regional Office for Europe, Copenhagen 2021, 1-3, https://iris.who.int/bitstream/handle/10665/381083/B09358-eng.pdf?sequence=1, 25. јун 2025.
World Health Organization, Regional Office for Europe, Country case study on the integrated delivery of long-term care: Denmark, World Health Organization, Regional Office for Europe, Copenhagen 2019, 7, https://iris.who.int/handle/10665/352847, 25. јун 2025.
World Health Organization, Regional Office for Europe, Country case study on the integrated delivery of long term care: Portugal, World Health Organization, Regional Office for Europe, Copenhagen 2020, 5-6, https://iris.who.int/bitstream/handle/10665/352857/WHO-EURO-2022-5270-45034-64151-eng.pdf?sequence=1, 25. јун 2025.
World Health Organization, The solid facts - Home care in Europe, World Health Organization, Regional Office for Europe, Milan 2008, 5-9, https://iris.who.int/bitstream/handle/10665/328766/9789289042819-eng.pdf, 25. јун 2025.
Directive (EU) 2019/1158 of the European Parliament and of the Council of 20 June 2019 on work-life balance for parents and carers and repealing Council Directive 2010/18/EU, OJ L 188, 12.7.2019, 79–93.
„European Pillar of Social Rights“, Oxford Encyclopedia of EU Law, март 2022, https://opil.ouplaw.com/abstract/10.1093/law-oeeul/law-oeeul-e3, 28. јул 2025.
Eurofound, Long term care workforce: Employment and working conditions, Publications Office of the European Union, Luxembourg 2020.
Eurofound, Undeclared care work in the EU: Policy approaches to a complex socioeconomic challenge, Publications Office of the European Union, Luxembourg 2025.
European Commission and Economic Policy Committee (EPC), The 2021 Ageing Report: Economic and Budgetary Projections for the EU Member States (2019–2070), Institutional Paper 148, Luxembourg 2021.
European Commission and Social Protection Committee, Adequate Social Protection for Long term Care Needs in an Ageing Society, Publications Office of the European Union, Luxembourg 2014.
European Commission, Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions - on the European care strategy, COM(2022) 440 final, Brussels 2022.
European Commission, Communication on enabling the digital transformation of health and care in the Digital Single Market; empowering citizens and building a healthier society, COM(2018) 233 final, Brussels 2018.
European Commission, European Pillar of Social Rights, proclaimed on 17 November 2017, Official Journal of the European Union, C 428, 13 December 2017.
European Commission, Long-term care report: Trends, challenges and opportunities in an ageing society, Publications Office of the European Union, Luxembourg 2021.
European Charter of the Rights and Responsibilities of Older People in Need of Long-Term Care and Assistance, AGE Platform Europe & European Commission, 2010, https://www.age-platform.eu/sites/default/files/European%20Charter_EN.pdf, 15. јун 2025.
Organisation for Economic Co operation and Development, Integrating Services for Older People in Lithuania, OECD, Paris 2022, 4, 20, https://www.oecd.org/content/dam/oecd/en/publications/reports/2022/11/integrating-services-for-older-people-in-lithuania_a84298e4/c74c44be-en.pdf?utm_source=chatgpt.com, 25. јун 2025.
Organisation for Economic Co operation and Development, Towards person centered integrated care: Aligning the health service workforce in Ireland with the needs of the person and population. Situation Analysis Report, OECD, Paris, 2025, 6, https://www.oecd.org/content/dam/oecd/en/about/programmes/dg-reform/ireland/23IE04%20Ireland%20-%20Situation%20Analysis%20Report.pdf, 20. јун 2025.
Ревидирана Европска социјална повеља (Revised European Social Charter), усвојена 3. маја 1996. године, ступила на снагу 1. јула 1999. Савет Европе, CETS No. 163.
Slavina Spasova et al., Challenges in Long-Term Care in Europe: A Study of National Policies, European Social Policy Network (ESPN), European Commission, Brussels 2018.
Stanisława Golinowska et al., Long-term Care for the Elderly: Challenges and Policy Options, CASE Network Reports No. 93, Center for Social and Economic Research, Warsaw 2013, 42–44.
The Council of the European Union, Council Recommendation on access to affordable high-quality long-term care, COM (2022) 441 final, OJ C 476, 15. 12. 2022, 1–11.
UN Women, A toolkit on paid and unpaid care work, New York 2022.
Francesco Colombo et al., Help Wanted? Providing and Paying for Long-Term Care, OECD Health Policy Studies, OECD Publishing, Paris 2011.
Horizon Europe, Work Programme 2025, General Introduction, European Commission Decision C(2025) 2779 of 14 May 2025.
Charter of Fundamental Rights of the European Union, Official Journal of the European Union C 326/391, 26.10.2012, 391-407.
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2026/01/15
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