Demand of long‐term care and benefit eligibility across European countries

Abstract

In this paper, we study how elderly individuals adjust their informal long-term care utilization to changes in the provision of formal care. Despite this is crucial to design effective policies of formal elderly care, empirical evidence is scant due to the lack of credible identification strategies to account for the endogeneity of formal care. We propose a novel instrument, an index that captures individuals' eligibility status for the long-term care programs implemented in the region of residence. Our estimates, which are robust to a number of different specifications, suggest that higher formal care provision would lead to an increase in informal care utilization as well. In the context of current theoretical economic model of care use, this result points to the existence of a substantial unmet demand of care among older people in Europe.

Does the amount of formal care affect informal care? Evidence among over-60s in France

“…Comparison with previous results Our results can be compared to those of three recent studies [ 1 , 2 , 8 ]. 27 Using SHARE data, Carrino et al [ 8 ] estimate the causal effect of formal care on informal care use, finding that the amount of formal care has a positive effect on both the extensive and intensive margins of informal care. This difference with our results has several possible explanations.…”

“…Two-part model We aim to show that there is a causal association between variations in the amount of formal care used and informal care received—both at the extensive and intensive margins. We use a two-part model (TPM) combined with an instrumental variable approach [ 14 ], 17 as has already been used in studies of long term care arrangements [ 6 , 8 ].…”

“…The causal impact of formal care on informal care has seldom been studied. The only published study on this question that we are aware of investigates arrangements in Austria, Belgium, Germany and France [ 8 ]. Formal care is instrumented by variations in long-term care program eligibility.…”

Analysis of the Influencing Factors on the Preferences of the Elderly for the Combination of Medical Care and Pension in Long-Term Care Facilities Based on the Andersen Model

“…However, it is worth noting that in this survey, the proportion of elderly people choosing CMCP institutions is much higher than the proportion of elderly people willing to choose CMCP institutions, as surveyed by our project team in 2013 (2.86%) [ 25 , 26 , 27 ]. A cross-sectional survey was performed by our project team across 173 communities in Xiamen, China, in 2013.…”

Formal home care use and spousal health outcomes

“…Perdrix and Roquebert (2019), using French data, find that using more hours of formal home care reduces informal caregiving (i.e., substitutability). However, Carrino et al (2018), using data for France, Germany, Austria, and Belgium, find evidence of complementarity.…”