Although the aging of the populations of the developed world, and the huge amounts of care needed to accommodate these aging populations, is considered to be one of the major policy problems for now and the near future [
2], international comparative research including a broad number of countries is scarce. The main reason for this can be found in the complexity of the subject and the problems that are encountered concerning definitions and concepts in this area, which is found somewhere between health care, social services and informal care [
3]. Substantial differences exist between European countries regarding all relevant aspects of care for the elderly, usually referred to as long-term care (LTC). Differences exist in the way countries organize care for the elderly; some countries rely heavily on family care, whereas others provide care in the form of publicly funded institutions and/or professional home care providers [
4,
5]. LTC expenditures vary accordingly [
2,
6] and there is a big north/south divide in the patterns of LTC in Europe [
7,
8]. As a result of the fuzzy boundaries between family care, social care and medical services, LTC research is notoriously complicated. This is also reflected in the validity, reliability and comparability of official statistics (see, for example, Van Mosseveld
et al. [
9]). One of the few research groups that tackled the international comparison of LTC is an Italian group, led by Damiani, who decided to use the available statistical data anyway (Damiani G
et al. Patterns of long term care in 29 European countries: evidence from an exploratory study.)[
1], showing that the use of international databases can lead to valuable results, and that sophisticated statistical methods can be meaningfully applied. The study of Damiani
et al. contains all 27 European Union (EU)-member states plus Norway and Iceland (not Switzerland) and covers a recent five-year period (2003 to 2007). The authors use eight indicators derived from international databases, such as the Organisation for Economic Co-operation and Development (OECD) health data [
6] and Eurostat data [
10], about the health and functional status of the elderly (65 and older) population, the supply and utilization of LTC services and LTC expenditure.
The use of international databases brings about some additional limitations besides the validity of the data. Firstly, the databases are focused on utilization and expenditure of formal care. Data on family values concerning LTC and data on informal care are either lacking or, if available, often cover one year only and are thus not suitable for trend studies. Secondly, the scope of the database can be limited. For instance, the Eurostat database [
10] only includes countries that are members of the EU and consequently data on Iceland, Norway and Switzerland are missing. As a result of the use of different definitions of LTC, data lacking in one database cannot simply be complemented from the other database. On the other hand, an advantage of these databases is that at least some efforts have been made to make the data comparable across countries.
Furthermore, the observation of a Danish poet, Piet Hein, who stated that experts seem to enjoy explaining why something cannot be done [
11], appears to be valid here; experts seem to discourage the use of these databases (the OECD database even gives a message warning of the dangers of using data from different countries each time an international comparison is made). This may discourage the use of these databases, which, in our opinion, contain valuable information. In this respect we welcome the study of Damiani
et al. (Damiani G
et al. Patterns of long term care in 29 European countries: evidence from an exploratory study [
1]).