IDEAS home Printed from https://ideas.repec.org/a/spr/hecrev/v10y2020i1d10.1186_s13561-020-00272-1.html
   My bibliography  Save this article

Shadow and extended shadow cost sharing associated to informal long-term care: the case of Spain

Author

Listed:
  • Raúl Del Pozo-Rubio

    (University of Castilla-La Mancha)

  • Pablo Moya-Martínez

    (University of Castilla-La Mancha)

  • Marta Ortega-Ortega

    (Complutense University of Madrid)

  • Juan Oliva-Moreno

    (University of Castilla-La Mancha)

Abstract

Background A large part of the long-term care is provided by non-professional caregivers, generally without any monetary payment but a value economic of time invested. The economic relevance of informal caregivers has been recognized in Spain; however, public provision may still be scarce. The objective of this paper is to estimate the economic burden associated with informal long-term care that should assume the families through a new concept of cost sharing that consider opportunity costs of time provided by informal caregivers. Methods The study sample includes all dependent adults in Spain. Socioeconomic information and the number of hours of informal care was collected through the Spanish Disability and Dependency Survey. The terms of shadow and extended shadow cost sharing were defined as the difference between the maximum potential amount of money that families could receive for the provision of informal care and the amount that actually they received and the value of informal care time with respect to the amount received, respectively. Results 53.87% of dependent persons received an economic benefit associated to informal care. The average weekly hours of care were 71.59 (92.62 without time restrictions). Shadow cost sharing amounted to, on average, two thirds, whereas the State financed the remaining third. In terms of extended shadow cost sharing, the State financed between 3% and 10% of informal care provided by caregivers. Conclusions This study reveals the deficient support received for the provision of informal care in Spain. More than 90% of informal care time is not covered by the economic benefits that families receive from the State.

Suggested Citation

  • Raúl Del Pozo-Rubio & Pablo Moya-Martínez & Marta Ortega-Ortega & Juan Oliva-Moreno, 2020. "Shadow and extended shadow cost sharing associated to informal long-term care: the case of Spain," Health Economics Review, Springer, vol. 10(1), pages 1-12, December.
  • Handle: RePEc:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00272-1
    DOI: 10.1186/s13561-020-00272-1
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1186/s13561-020-00272-1
    File Function: Abstract
    Download Restriction: no

    File URL: https://libkey.io/10.1186/s13561-020-00272-1?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. Tarja Viitanen, 2007. "Informal And Formal Care In Europe," Working Papers 2007010, The University of Sheffield, Department of Economics, revised Jun 2007.
    2. Courtin, Emilie & Jemiai, Nadia & Mossialos, Elias, 2014. "Mapping support policies for informal carers across the European Union," Health Policy, Elsevier, vol. 118(1), pages 84-94.
    3. K. Bolin & B. Lindgren & P. Lundborg, 2008. "Informal and formal care among single‐living elderly in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 393-409, March.
    4. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    5. Bernard van denBerg & Werner Brouwer & Job van Exel & Marc Koopmanschap, 2005. "Economic valuation of informal care: the contingent valuation method applied to informal caregiving," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 169-183, February.
    6. Sergi Jiménez-Martín & Cristina Prieto, 2012. "The trade-off between formal and informal care in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 461-490, August.
    7. Hirst, Michael, 2005. "Carer distress: A prospective, population-based study," Social Science & Medicine, Elsevier, vol. 61(3), pages 697-708, August.
    8. van den Berg, Bernard & Al, Maiwenn & Brouwer, Werner & van Exel, Job & Koopmanschap, Marc, 2005. "Economic valuation of informal care: The conjoint measurement method applied to informal caregiving," Social Science & Medicine, Elsevier, vol. 61(6), pages 1342-1355, September.
    9. Rie Fujisawa & Francesca Colombo, 2009. "The Long-Term Care Workforce: Overview and Strategies to Adapt Supply to a Growing Demand," OECD Health Working Papers 44, OECD Publishing.
    10. Astrid Kiil & Kurt Houlberg, 2014. "How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 813-828, November.
    11. Juan Oliva-Moreno & Luz Peña-Longobardo & Cristina Vilaplana-Prieto, 2015. "An Estimation of the Value of Informal Care Provided to Dependent People in Spain," Applied Health Economics and Health Policy, Springer, vol. 13(2), pages 223-231, April.
    12. Yardim, Mahmut Saadi & Cilingiroglu, Nesrin & Yardim, Nazan, 2010. "Catastrophic health expenditure and impoverishment in Turkey," Health Policy, Elsevier, vol. 94(1), pages 26-33, January.
    13. Bernard van den Berg & Pol Spauwen, 2006. "Measurement of informal care: an empirical study into the valid measurement of time spent on informal caregiving," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 447-460, May.
    14. Julio López-Bastida & Juan Oliva-Moreno & Renata Linertová & Pedro Serrano-Aguilar, 2016. "Social/economic costs and health-related quality of life in patients with rare diseases in Europe," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(1), pages 1-5, April.
    15. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    16. Juan Oliva-Moreno & Luz María Peña-Longobardo & Leticia García-Mochón & María del Río Lozano & Isabel Mosquera Metcalfe & María del Mar García-Calvente, 2019. "The economic value of time of informal care and its determinants (The CUIDARSE Study)," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-15, May.
    17. Kronenberg, Christoph & Barros, Pedro Pita, 2014. "Catastrophic healthcare expenditure – Drivers and protection: The Portuguese case," Health Policy, Elsevier, vol. 115(1), pages 44-51.
    18. Emmanouil Mentzakis & Paul McNamee & Mandy Ryan, 2009. "Who cares and how much: exploring the determinants of co-residential informal care," Review of Economics of the Household, Springer, vol. 7(3), pages 305-305, September.
    19. Sarah-Jo Sinnott & Claire Buckley & David O′Riordan & Colin Bradley & Helen Whelton, 2013. "The Effect of Copayments for Prescriptions on Adherence to Prescription Medicines in Publicly Insured Populations; A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-11, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 8th June 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-06-08 11:00:08

    Citations

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


    Cited by:

    1. Raúl Del Pozo-Rubio & Fernando Bermejo-Patón & Pablo Moya-Martínez, 2022. "Impact of implementation of the Dependency Act on the Spanish economy: an analysis after the 2008 financial crisis," International Journal of Health Economics and Management, Springer, vol. 22(1), pages 111-128, March.
    2. David Cantarero & Marta Pascual & Beatriz Rodríguez-Sánchez, 2022. "Differences in the Use of Formal and Informal Care Services among Older Adults after the Implementation of the Dependency Act in Spain," Hacienda Pública Española / Review of Public Economics, IEF, vol. 240(1), pages 61-93, March.
    3. Gutiérrez-Robledo, Luis Miguel & Jácome-Maldonado, Luis David & González-Rivero, Cynthia Beatriz & Lozano-Juárez, Luis Raymundo & Tella-Vega, Pamela & García-Peña, Carmen, 2022. "Monetary cost estimation of care for functionally dependent older adults in Mexico," The Journal of the Economics of Ageing, Elsevier, vol. 21(C).
    4. Beatriz Rodríguez-Sánchez & Marta Pascual Sáez & David Cantarero-Prieto, 2021. "Dependent, Poorer, and More Care-Demanding? An Analysis of the Relationship between Being Dependent, Household Income, and Formal and Informal Care Use in Spain," IJERPH, MDPI, vol. 18(8), pages 1-17, April.

    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. Juan Oliva-Moreno & Marta Trapero-Bertran & Luz Maria Peña-Longobardo & Raúl del Pozo-Rubio, 2017. "The Valuation of Informal Care in Cost-of-Illness Studies: A Systematic Review," PharmacoEconomics, Springer, vol. 35(3), pages 331-345, March.
    2. Bauer, Jan Michael & Sousa-Poza, Alfonso, 2015. "Impacts of Informal Caregiving on Caregiver Employment, Health, and Family," IZA Discussion Papers 8851, Institute of Labor Economics (IZA).
    3. Juan Oliva-Moreno & Luz María Peña-Longobardo & Leticia García-Mochón & María del Río Lozano & Isabel Mosquera Metcalfe & María del Mar García-Calvente, 2019. "The economic value of time of informal care and its determinants (The CUIDARSE Study)," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-15, May.
    4. Emmanouil Mentzakis & Mandy Ryan & Paul McNamee, 2011. "Using discrete choice experiments to value informal care tasks: exploring preference heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 930-944, August.
    5. Rapp, Thomas & Grand, Alain & Cantet, Christelle & Andrieu, Sandrine & Coley, Nicola & Portet, Florence & Vellas, Bruno, 2011. "Public financial support receipt and non-medical resource utilization in Alzheimer's disease results from the PLASA study," Social Science & Medicine, Elsevier, vol. 72(8), pages 1310-1316, April.
    6. Urwin, Sean & Lau, Yiu-Shing & Grande, Gunn & Sutton, Matthew, 2023. "Informal caregiving and the allocation of time: implications for opportunity costs and measurement," Social Science & Medicine, Elsevier, vol. 334(C).
    7. Emmanouil Mentzakis & Mandy Ryan & Paul McNamee, 2014. "Modelling Heterogeneity and Uncertainty in Contingent Valuation: an Application to the Valuation of Informal Care," Scottish Journal of Political Economy, Scottish Economic Society, vol. 61(1), pages 1-25, February.
    8. Kyriopoulos, Ilias & Nikoloski, Zlatko & Mossialos, Elias, 2021. "Financial protection in health among the middle-aged and elderly: Evidence from the Greek economic recession," Health Policy, Elsevier, vol. 125(9), pages 1256-1266.
    9. Chantzaras, Athanasios E. & Yfantopoulos, John N., 2018. "Financial protection of households against health shocks in Greece during the economic crisis," Social Science & Medicine, Elsevier, vol. 211(C), pages 338-351.
    10. Cristina Vilaplana Prieto & Sergi Jiménez-Martín, 2015. "Unmet needs in formal care: kindling the spark for caregiving behavior," International Journal of Health Economics and Management, Springer, vol. 15(2), pages 153-184, June.
    11. van den Berg, Bernard & Fiebig, Denzil G. & Hall, Jane, 2014. "Well-being losses due to care-giving," Journal of Health Economics, Elsevier, vol. 35(C), pages 123-131.
    12. Urwin, Sean & Lau, Yiu-Shing & Grande, Gunn & Sutton, Matt, 2021. "The extent and predictors of discrepancy between provider and recipient reports of informal caregiving," Social Science & Medicine, Elsevier, vol. 277(C).
    13. Raúl Del Pozo-Rubio & Isabel Pardo-García & Francisco Escribano-Sotos, 2020. "Financial Catastrophism Inherent with Out-of-Pocket Payments in Long Term Care for Households: A Latent Impoverishment," IJERPH, MDPI, vol. 17(1), pages 1-19, January.
    14. Isaac Aranda-Reneo & Luz María Peña-Longobardo & Juan Oliva-Moreno & Svenja Litzkendorf & Isabelle Durand-Zaleski & Eduardo F. Tizzano & Julio López-Bastida, 2020. "The Burden of Spinal Muscular Atrophy on Informal Caregivers," IJERPH, MDPI, vol. 17(23), pages 1-12, December.
    15. 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.
    16. 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.
    17. Diana Albrecht & Tanja Wollensak & Christian Ernst & Clemens Becker & Martin Hautzinger & Klaus Pfeiffer, 2016. "Costs of informal care in a sample of German geriatric stroke survivors," European Journal of Ageing, Springer, vol. 13(1), pages 49-61, March.
    18. Sergi Jiménez-Martín & Cristina Vilaplana Prieto, 2015. "Do Spanish Informal Caregivers Come to the Rescue of Dependent People with Formal Care Unmet Needs?," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 37(2), pages 243-259.
    19. Leporatti Lucia & Montefiori Marcello, 2020. "The Challenge of Organizing Elderly Care Programmes: Optimal Policy Design under Complete and Asymmetric Information," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 20(1), pages 1-15, January.
    20. Leonarda G. M. Bremmers & Leona Hakkaart-van Roijen & Eleonora S. Gräler & Carin A. Uyl-de Groot & Isabelle N. Fabbricotti, 2022. "How Do Shifts in Patients with Mental Health Problems’ Formal and Informal Care Utilization Affect Informal Caregivers?: A COVID-19 Case Study," IJERPH, MDPI, vol. 19(24), pages 1-16, December.

    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:spr:hecrev:v:10:y:2020:i:1:d:10.1186_s13561-020-00272-1. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com/economics/journal/13561 .

    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.