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Preferences for long-term care services: Willingness to pay estimates derived from a discrete choice experiment

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  • Nieboer, Anna P.
  • Koolman, Xander
  • Stolk, Elly A.

Abstract

Ageing populations increase pressure on long-term care. Optimal resource allocation requires an optimal mix of care services based on costs and benefits. Contrary to costs, benefits remain largely unknown. This study elicits preferences in the general elderly population for long-term care services for varying types of patients. A discrete choice experiment was conducted in a general population subsample aged 50-65 years (NÂ =Â 1082) drawn from the Dutch Survey Sampling International panel. To ascertain relative preferences for long-term care and willingness to pay for these, participants were asked to choose the best of two care scenarios for four groups of hypothetical patients: frail and demented elderly, with and without partner. The scenarios described long-term care using ten attributes based on Social Production Function theory: hours of care, organized social activities, transportation, living situation, same person delivering care, room for individual preferences, coordination of services, punctuality, time on waiting list, and co-payments. We found the greatest value was attached to same person delivering care and transportation services. Low value was attached to punctuality and room for individual preferences. Nursing homes were generally considered to be detrimental for well-being except for dementia patients without a partner. Overall, long-term care services were thought to produce greatest well-being for the patients 'without a partner' and those 'with dementia'. Individuals combining these two risk factors would benefit the most from all services except transportation which was considered more important for the frail elderly. The results support the notion that long-term care services represent different value for different types of patients and that the value of a service depends upon the social context. Examination of patient profiles confirmed the notion that physical, mental and social vulnerability affect valuation of the services. Policy-making would profit from allocation models in which budgetary requirements of different services can be balanced against the well-being they produce for individuals.

Suggested Citation

  • Nieboer, Anna P. & Koolman, Xander & Stolk, Elly A., 2010. "Preferences for long-term care services: Willingness to pay estimates derived from a discrete choice experiment," Social Science & Medicine, Elsevier, vol. 70(9), pages 1317-1325, May.
    • Handle: RePEc:eee:socmed:v:70:y:2010:i:9:p:1317-1325
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    1. Amilon, Anna & Ladenburg, Jacob & Siren, Anu & Vernstrøm Østergaard, Stine, 2020. "Willingness to pay for long-term home care services: Evidence from a stated preferences analysis," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    2. de Bresser, Jochem & Knoef, Marike & van Ooijen, Raun, 2022. "Preferences for in-kind and in-cash home care insurance," Journal of Health Economics, Elsevier, vol. 84(C).
    3. van Ooijen, Raun & de Bresser, Jochem & Knoef, Marike, 2019. "Preferences for Long-Term Care Services: Bequests, Informal Care and Health Expectations," Other publications TiSEM a60a8e39-57eb-48e4-89b4-e, Tilburg University, School of Economics and Management.
    4. Walsh, Sharon & O'Shea, Eamon & Pierse, Tom & Kennelly, Brendan & Keogh, Fiona & Doherty, Edel, 2020. "Public preferences for home care services for people with dementia: A discrete choice experiment on personhood," Social Science & Medicine, Elsevier, vol. 245(C).
    5. Michael Clark & Domino Determann & Stavros Petrou & Domenico Moro & Esther Bekker-Grob, 2014. "Discrete Choice Experiments in Health Economics: A Review of the Literature," PharmacoEconomics, Springer, vol. 32(9), pages 883-902, September.
    6. Akaichi, Faical & Costa-Font, Joan & Frank, Richard, 2020. "Uninsured by Choice? A choice experiment on long term care insurance," Journal of Economic Behavior & Organization, Elsevier, vol. 173(C), pages 422-434.
    7. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    8. Song, Shan & Wang, De & Zhu, Wei & Wang, Can, 2020. "Study on the spatial configuration of nursing homes for the elderly people in Shanghai: Based on their choice preference," Technological Forecasting and Social Change, Elsevier, vol. 152(C).
    9. de Bresser, Jochem & Knoef, Marike & van Ooijen, Raun, 2021. "Preferences for In-Kind and In-Cash Home Care Insurance," Discussion Paper 2021-033, Tilburg University, Center for Economic Research.
    10. 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).
    11. Finkelstein, Eric A. & Bilger, Marcel & Flynn, Terry N. & Malhotra, Chetna, 2015. "Preferences for end-of-life care among community-dwelling older adults and patients with advanced cancer: A discrete choice experiment," Health Policy, Elsevier, vol. 119(11), pages 1482-1489.
    12. Genie, Mesfin G. & Nicoló, Antonio & Pasini, Giacomo, 2020. "The role of heterogeneity of patients’ preferences in kidney transplantation," Journal of Health Economics, Elsevier, vol. 72(C).
    13. He, Alex Jingwei & Qian, Jiwei & Chan, Wai-sum & Chou, Kee-lee, 2021. "Preferences for private long-term care insurance products in a super-ageing society: A discrete choice experiment in Hong Kong," Social Science & Medicine, Elsevier, vol. 270(C).
    14. Teahan, Áine & Walsh, Sharon & Doherty, Edel & O'Shea, Eamon, 2021. "Supporting family carers of people with dementia: A discrete choice experiment of public preferences," Social Science & Medicine, Elsevier, vol. 287(C).
    15. Mihic, Marko M. & Todorovic, Marija Lj. & Obradovic, Vladimir Lj., 2014. "Economic analysis of social services for the elderly in Serbia: Two sides of the same coin," Evaluation and Program Planning, Elsevier, vol. 45(C), pages 9-21.
    16. Nieboer, Anna P. & Cramm, Jane M., 2018. "How do older people achieve well-being? Validation of the Social Production Function Instrument for the level of well-being–short (SPF-ILs)," Social Science & Medicine, Elsevier, vol. 211(C), pages 304-313.
    17. Cramm, Jane M. & Strating, Mathilde M.H. & Bal, Roland & Nieboer, Anna P., 2013. "A large-scale longitudinal study indicating the importance of perceived effectiveness, organizational and management support for innovative culture," Social Science & Medicine, Elsevier, vol. 83(C), pages 119-124.

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