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Trust in the publicly financed care system and willingness to pay for long-term care: A discrete choice experiment in Denmark

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  • Amilon, Anna
  • Kjær, Agnete Aslaug
  • Ladenburg, Jacob
  • Siren, Anu

Abstract

Aging populations put pressure on the provision and financing of long-term care (LTC) services in many countries. The projected increase in LTC expenditures may in particular constitute a threat to the future sustainability of public budgets in welfare states, where LTC is financed through taxes. To accommodate the increasing number of 80+ year-olds in society, policy-makers and service administrators need a better understanding of care preferences among future older adults: What types of services do older citizens prefer most, and which factors shape their LTC preferences? A discrete choice experiment (DCE) was administered to a representative sample of the Danish population aged 54–64 from May to July 2019 (n = 1154), investigating which factors shape individuals' preferences and willingness-to-pay (WTP) for their future LTC. Our results reveal that respondents are willing to make additional out-of-pocket payments to supplement the care provided for free by the municipality. The WTP was highest for services such as receiving help from a regular care team ($129 per month) and an extra shower a week ($116 per month). Moreover, we find heterogeneous care preferences, with three user characteristics associated with higher WTP for services: higher education, high wealth, and a low trust in the publicly financed care system. Our results raise concerns that inequalities between relatively more- and less-resourceful older adults may increase in Scandinavian-type welfare states in the future. Such increasing inequality in service provision may undermine citizens’ trust in and support of the publicly financed care system.

Suggested Citation

  • Amilon, Anna & Kjær, Agnete Aslaug & Ladenburg, Jacob & Siren, Anu, 2022. "Trust in the publicly financed care system and willingness to pay for long-term care: A discrete choice experiment in Denmark," Social Science & Medicine, Elsevier, vol. 311(C).
    • Handle: RePEc:eee:socmed:v:311:y:2022:i:c:s0277953622006384
    DOI: 10.1016/j.socscimed.2022.115332
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