Historical Changes and Cross-Country Comparisons of Long-Term Care Policy: A New Resource.

Abstract

Context: Individual behaviour is influenced by the current policy environment, but many of the outcomes observed today are consequences of how people reacted to policies implemented in the past. However, understanding long-term care (LTC) policy at the time of a given survey is a challenge to cross-country research, since many longitudinal studies of ageing are conducted over a decade or longer.

Perspective: The Gateway to Global Aging Data's LTC Policy Explorer is a publicly available, open-access data and information platform that collects detailed, harmonised historical policy information across countries and US states to support researchers interested in studying policy. As of May 2026, the LTC Policy Series includes detailed LTC system information for 22 countries and 35 US states, documented from as early as 1992. It includes policies that affect the scope, coverage, and limitations of care, such as eligibility criteria, system financing, benefits provided, and costs to the beneficiary. We provide examples of major shifts and trends in policy as well as significant variation in LTC systems around the world that could be beneficial to researchers and may inform or guide future policy decisions.

Implications: This perspective highlights the complexities and differences in LTC benefit policy across countries and US states, revealing the importance of documented historical policy as a resource for the broader policy research community. The Long-Term Care Policy Explorer can be used with longitudinal studies that collect relevant information for identifying care needs and means to understand population-level effects of certain policies, particularly as they relate to public LTC benefit eligibility.