Towards a typology of medical care in European long-term care homes

Abstract

PURPOSE: We aimed to describe the range of ways in which medical care for older people living in care homes across Europe is provided and to group these, using similarities and differences in current practice, into categories-a typology-that would enable future collaboration between countries. METHODS: A questionnaire-based survey comprising a mixture of closed and open questions was distributed in October 2025 to graduates of the European Academy for Medicine of Ageing (EAMA) course. RESULTS: Respondents from 19 countries answered the survey. Waiting time for a care home placement was two months or more in 68% of countries. Median survival after moving to a care home ranged from 1.3 to 3.4 years. Digitalized medical records were available in most care homes, but were usually not synchronized with hospital or GP records. Nurses were available around the clock, while doctors came on predetermined days or per request. The residents' medical care was broadly grouped into three categories: Specialist-led, structured admission systems, GP-led care with strong admission gatekeeping and predominantly GP-led with less formal admission process. CONCLUSIONS: There was a substantial heterogeneity of the care home settings across the 19 countries studied. The way that residents received care can be broadly grouped into three categories. These represented a continuum from highly involved, highly specialised models of medical care to less-specialized medical models that more closely resemble the routine primary care received by citizens living in their own homes.