The classification of distinct long-term care systems worldwide: the empirical application of an actor-centered multi-dimensional typology

Long-term care (LTC) systems vary between countries in several ways. One important difference exists with regard to the question of who, that is which type of corporate actor, takes over the main responsibility in providing, financing and regulating LTC. In this article, we employ a multi-dimensional, actor-centered typology of LTC systems to classify all distinct LTC systems existing worldwide at the point in time when they were first established. In doing so, the article contributes to comparative LTC research by including novel cases and adding a historical perspective. Our 18 cases fall into eight types, which we combine tentatively into three distinct clusters: A predominantly state regulated and financed cluster, a state regulated cluster with mixed financing and provision, and a cluster with private regulation and provision plus societal financing. We find that the state plays the major role in regulation (dominant in 16 countries) and financing (dominant in 11 countries), while in provision we see a broader distribution with societal and private for-profit actors taking a major role. Interestingly, and in contrast to healthcare systems, no societal pure type emerges, not even among social insurance countries.