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Socioeconomic Inequalities in Home-Care Use Across Regional Long-term Care Systems in Europe
[Demography of informal caregiving]

Author

Listed:
  • Ginevra Floridi
  • Ludovico Carrino
  • Karen Glaser
  • Candace Kemp

Abstract

ObjectivesWe examine whether socioeconomic inequalities in home-care use among disabled older adults are related to the contextual characteristics of long-term care (LTC) systems. Specifically, we investigate how wealth and income gradients in the use of informal, formal, and mixed home-care vary according to the degree to which LTC systems offer alternatives to families as the main providers of care (“de-familization”).MethodWe use survey data from SHARE on disabled older adults from 136 administrative regions in 12 European countries and link them to a regional indicator of de-familization in LTC, measured by the number of available LTC beds in care homes. We use multinomial multilevel models, with and without country fixed-effects, to study home-care use as a function of individual-level and regional-level LTC characteristics. We interact financial wealth and income with the number of LTC beds to assess whether socioeconomic gradients in home-care use differ across regions according to the degree of de-familization in LTC.ResultsWe find robust evidence that socioeconomic status inequalities in the use of mixed-care are lower in more de-familized LTC systems. Poorer people are more likely than the wealthier to combine informal and formal home-care use in regions with more LTC beds. SES inequalities in the exclusive use of informal or formal care do not differ by the level of de-familization.DiscussionThe results suggest that de-familization in LTC favors the combination of formal and informal home-care among the more socioeconomically disadvantaged, potentially mitigating health inequalities in later life.

Suggested Citation

  • Ginevra Floridi & Ludovico Carrino & Karen Glaser & Candace Kemp, 2021. "Socioeconomic Inequalities in Home-Care Use Across Regional Long-term Care Systems in Europe [Demography of informal caregiving]," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 76(1), pages 121-132.
    • Handle: RePEc:oup:geronb:v:76:y:2021:i:1:p:121-132.
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    File URL: http://hdl.handle.net/10.1093/geronb/gbaa139
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    References listed on IDEAS

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    1. Marco Albertini & Emmanuele Pavolini, 2017. "Unequal Inequalities: The Stratification of the Use of Formal Care Among Older Europeans," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 72(3), pages 510-521.
    2. Joan Costa‐Font & Edward C. Norton & Luigi Siciliani & Vincenzo Carrieri & Cinzia Di Novi & Cristina Elisa Orso, 2017. "Home Sweet Home? Public Financing and Inequalities in the Use of Home Care Services in Europe," Fiscal Studies, Institute for Fiscal Studies, vol. 38, pages 445-468, September.
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    1. Bo Hu & Javiera Cartagena-Farias & Nicola Brimblecombe, 2022. "Functional disability and utilisation of long-term care in the older population in England: a dual trajectory analysis," European Journal of Ageing, Springer, vol. 19(4), pages 1363-1373, December.

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