IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0176548.html
   My bibliography  Save this article

Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China

Author

Listed:
  • Fen Li
  • Xinye Fang
  • Jiechun Gao
  • Hansheng Ding
  • Changying Wang
  • Chunyan Xie
  • Yitong Yang
  • Chunlin Jin

Abstract

The need for formal care among the elderly population has been increasing due to their greater longevity and the evolution of family structure. We examined the determinants of the use and expenses of formal care among in-home elderly adults in Shanghai. A two-part model based on the data from the Shanghai Long-Term Care Needs Assessment Questionnaire was applied. A total of 8428 participants responded in 2014 and 7100 were followed up in 2015. The determinants of the probability of using formal care were analyzed in the first part of the model and the determinants of formal care expenses were analyzed in the second part. Demographic indicators, living arrangements, physical health status, and care type in 2014 were selected as independent variables. We found that individuals of older age; women; those with higher Activities of Daily Living (ADL) scores; those without spouse; those with higher income; those suffering from stroke, dementia, lower limb fracture, or advanced tumor; and those with previous experience of formal and informal care were more likely to receive formal care in 2015. Furthermore, age, income and formal care fee in 2014 were significant predictors of formal care expenses in 2015. Taken together, the results showed that formal care provision in Shanghai was not determined by ADL scores, but was instead more related to income. This implied an inappropriate distribution of formal care among elderly population in Shanghai. Additionally, it appeared difficult for the elderly to quit the formal care once they begun to use it. These results highlighted the importance of assessing the need for formal care, and suggested that the government offer guidance on formal care use for the elderly.

Suggested Citation

  • Fen Li & Xinye Fang & Jiechun Gao & Hansheng Ding & Changying Wang & Chunyan Xie & Yitong Yang & Chunlin Jin, 2017. "Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-10, April.
    • Handle: RePEc:plo:pone00:0176548
    DOI: 10.1371/journal.pone.0176548
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0176548
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0176548&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0176548?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Hanaoka, Chie & Norton, Edward C., 2008. "Informal and formal care for elderly persons: How adult children's characteristics affect the use of formal care in Japan," Social Science & Medicine, Elsevier, vol. 67(6), pages 1002-1008, September.
    2. Brenda Gannon & Bérengère Davin, 2010. "Use of formal and informal care services among older people in Ireland and France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 499-511, October.
    3. Van Houtven, Courtney Harold & Norton, Edward C., 2004. "Informal care and health care use of older adults," Journal of Health Economics, Elsevier, vol. 23(6), pages 1159-1180, November.
    4. Bonsang, Eric, 2009. "Does informal care from children to their elderly parents substitute for formal care in Europe?," Journal of Health Economics, Elsevier, vol. 28(1), pages 143-154, January.
    5. de Meijer, Claudine & Koopmanschap, Marc & d' Uva, Teresa Bago & van Doorslaer, Eddy, 2011. "Determinants of long-term care spending: Age, time to death or disability?," Journal of Health Economics, Elsevier, vol. 30(2), pages 425-438, March.
    6. Buntin, Melinda Beeuwkes & Zaslavsky, Alan M., 2004. "Too much ado about two-part models and transformation?: Comparing methods of modeling Medicare expenditures," Journal of Health Economics, Elsevier, vol. 23(3), pages 525-542, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kofi Awuviry-Newton & Kylie Wales & Meredith Tavener & Julie Byles, 2020. "Do factors across the World Health Organisation's International Classification of Functioning, Disability and Health framework relate to caregiver availability for community-dwelling older adults in G," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-15, May.
    2. Li, Yan, 2022. "Social care for disabled elderly women in urban China: The roles of the community," Social Science & Medicine, Elsevier, vol. 314(C).
    3. Hongjuan Liu & Lingzhong Xu & Hailing Yang & Yan Zhao & Xiaorong Luan, 2022. "Preferences in long-term care models and related factors among older adults: a cross-sectional study from Shandong Province, China," European Journal of Ageing, Springer, vol. 19(1), pages 27-35, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pieter Bakx & Claudine de Meijer & Frederik Schut & Eddy van Doorslaer, 2015. "Going Formal or Informal, Who Cares? The Influence of Public Long‐Term Care Insurance," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 631-643, June.
    2. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    3. Torbica, Aleksandra & Calciolari, Stefano & Fattore, Giovanni, 2015. "Does informal care impact utilization of healthcare services? Evidence from a longitudinal study of stroke patients," Social Science & Medicine, Elsevier, vol. 124(C), pages 29-38.
    4. Iegor Rudnytskyi & Joël Wagner, 2019. "Drivers of Old-Age Dependence and Long-Term Care Usage in Switzerland—A Structural Equation Model Approach," Risks, MDPI, vol. 7(3), pages 1-20, August.
    5. Rapp, Thomas & Ronchetti, Jérome & Sicsic, Jonathan, 2022. "Impact of formal care consumption on informal care use in Europe: What is happening at the beginning of dependency?," Health Policy, Elsevier, vol. 126(7), pages 632-642.
    6. Yoko Niimi, 2016. "The “Costs” of informal care: an analysis of the impact of elderly care on caregivers’ subjective well-being in Japan," Review of Economics of the Household, Springer, vol. 14(4), pages 779-810, December.
    7. James Gaughan & Hugh Gravelle & Rita Santos & Luigi Siciliani, 2017. "Long-term care provision, hospital bed blocking, and discharge destination for hip fracture and stroke patients," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 311-331, September.
    8. Michio Yuda & Jinkook Lee, 2016. "Effects of Informal Caregivers’ Health on Care Recipients," The Japanese Economic Review, Springer, vol. 67(2), pages 192-210, June.
    9. Alexander L. Janus & Alison Koslowski, 2020. "Whose responsibility? Elder support norms regarding the provision and financing of assistance with daily activities across economically developed countries," European Journal of Ageing, Springer, vol. 17(1), pages 95-108, March.
    10. David C. Grabowski & Edward C. Norton & Courtney H. Van Houtven, 2012. "Informal Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 30, Edward Elgar Publishing.
    11. Pieter Bakx & Frederik Schut & Eddy Doorslaer, 2015. "Can universal access and competition in long-term care insurance be combined?," International Journal of Health Economics and Management, Springer, vol. 15(2), pages 185-213, June.
    12. Evelyn Korn & Matthias Wrede, 2012. "The effect of long term subsidies on female labor supply and fertility," MAGKS Papers on Economics 201243, Philipps-Universität Marburg, Faculty of Business Administration and Economics, Department of Economics (Volkswirtschaftliche Abteilung).
    13. Matteo Lippi Bruni & Cristina Ugolini, 2016. "Delegating home care for the elderly to external caregivers? An empirical study on Italian data," Review of Economics of the Household, Springer, vol. 14(1), pages 155-183, March.
    14. Miriam Marcén & José Molina, 2012. "Informal caring-time and caregiver satisfaction," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(6), pages 683-705, December.
    15. Sean Urwin & Yiu‐Shing Lau & Thomas Mason, 2019. "Investigating the relationship between formal and informal care: An application using panel data for people living together," Health Economics, John Wiley & Sons, Ltd., vol. 28(8), pages 984-997, August.
    16. James Gaughan & Hugh Gravelle & Luigi Siciliani, 2014. "Testing the bed-blocking hypothesis: does higher supply of nursing and care homes reduce delayed hospital discharges?," Working Papers 102cherp, Centre for Health Economics, University of York.
    17. Ando Michihito & Furuichi Masato & Kaneko Yoshihiro, 2021. "Does universal long-term care insurance boost female labor force participation? Macro-level evidence," IZA Journal of Labor Policy, Sciendo & Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 11(1), pages 1-50, May.
    18. Claudine de Meijer & Pieter Bakx & Eddy van Doorslaer & Marc Koopmanschap, 2015. "Explaining Declining Rates of Institutional LTC Use in the Netherlands: A Decomposition Approach," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 18-31, March.
    19. Shinya Sugawara, 2022. "What composes desirable formal at-home elder care? An analysis for multiple service combinations," The Japanese Economic Review, Springer, vol. 73(2), pages 373-402, April.
    20. Zhang, Wei & Sun, Huiying & L'Heureux, Jacynthe, 2021. "Substitutes or complements between informal and formal home care in the Canadian longitudinal study on aging: Functional impairment as an effect modifier," Health Policy, Elsevier, vol. 125(9), pages 1267-1275.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0176548. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.