Long-term care planning and sustainability of the care system in the region

Rajer, Carmen (author), Bogataj, David (author), Bogataj, Marija (author), Drobne, Samo (author)

Background/Objectives: This study examines the relationship between user preferences, spatial accessibility, and the financial sustainability of long-term care (LTC) systems, with a focus on Slovenia and the Posavje region. The analysis compares different care models, including long-term home care (LTHC), institutional care, and community-based housing solutions such as sheltered housing and “silver villages”. Methods: A mixed-methods approach was applied, combining qualitative interviews, survey data, spatial analysis, mobility-related operational assessment, and cost estimation. The survey included 1005 in dividuals, of whom 475 provided valid responses. Statistical analysis was conducted using chi-square tests and the Agresti–Caffo method to examine differences in care preferences and selected proportions across respondent groups. Results: Statistically significant differ ences in LTC preferences across age groups were identified. Most respondents preferred care options located close to their homes, with the majority unwilling to relocate more than 10 km and a substantial share preferring distances below 5 km. The findings further indicate that travel-related costs for care providers in rural areas are considerable and, in the Municipality of Krško, comparable to the estimated monthly housing costs in special ized community-based units. Cost comparisons suggest that reductions in travel-related operational costs could offset a substantial share of the estimated housing-related costs. Conclusions: The results indicate that sustainable LTC systems require not only adequate service capacity and funding but also spatially coordinated care models aligned with user preferences and long-term sustainability. The findings contribute to strategic LTC planning and support the development of integrated, community-based care systems in geographically dispersed regions.

• Language: English
• Keywords: long-termcare, long-termhomecare, community-basedcare, ageingpopulation, spatial accessibility, travel costs, rural areas, care preferences, integrated care, Slovenia
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: FGG - Faculty of Civil and Geodetic Engineering
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: 18 str.
• Numbering: Vol. 14, issue 12, art. 1633
• PID: 20.500.12556/RUL-183670
• UDC: 364.4
• ISSN on article: 2227-9032
• DOI: 10.3390/healthcare14121633
• COBISS.SI-ID: 281864963
• Publication date in RUL: 17.06.2026

Record is a part of a journal

• Title: Healthcare
• Shortened title: Healthcare
• Publisher: MDPI
• ISSN: 2227-9032
• COBISS.SI-ID: 520110873

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: dolgotrajna oskrba, dolgotrajna oskrba na domu, oskrba v lokalni skupnosti, staranje prebivalstva, prostorska dostopnost, potni stroški, podeželje, preference glede oskrbe, celostna oskrba, Slovenija