IMPACT ASSESSMENT OF THE NURSING CARE REFORM

The study evaluates the outcomes of the nursing care reform that came into effect in 2023, focusing on the affordability and availability of round-the-clock residential care, the conditions necessary to ensure service quality, local government funding, and the development of services that support people in living at home. The analysis covers the period 2021–2025 and informs recommendations for the further development of the long-term care system.

The study shows that the nursing care reform improved the affordability of residential care and reduced the share of total service costs borne by service users and their families. Their share fell from 78% in 2021 to 53% in 2025. Following the reform, service users’ pensions were, on average, sufficient to cover their contribution to care costs. However, there were substantial differences between individuals, and nearly a quarter had pensions that did not cover the costs they were required to pay.

Following the reform, both the use of residential care and the number of care places increased, while compliance with care staffing requirements improved. At the same time, total service costs rose rapidly, as did the financial and administrative burden on local governments. The reform did not lead to sufficient development of services that support people in living at home.

The findings indicate that the long-term care system requires more comprehensive development. We recommend simplifying the financial support system for residential care and giving equal priority to the development of services that support people in living at home and in the community. Population ageing will increase the need for both care services and their funding.