IDEAS home Printed from https://ideas.repec.org/a/spr/jecrev/v73y2022i2d10.1007_s42973-019-00031-w.html
   My bibliography  Save this article

What composes desirable formal at-home elder care? An analysis for multiple service combinations

Author

Listed:
  • Shinya Sugawara

    (Tokyo University of Science)

Abstract

I estimate the relationship between combinations of multiple services for formal at-home elder care and health status. As a reasonable substitute for expensive institutional care, at-home formal elderly care is gaining popularity in developed countries. Because at-home care is composed of many small and complementary services, the relationship between multiple service combinations and health status requires analysis. However, the high dimensionality of these combinations makes estimation difficult. This study employs a regression analysis using care service combinations as cross-dummy explanatory variables. To reduce the combination dimensions, I select the combinations that are purchased jointly by a sufficient number of the elderly using basket analysis. I apply this method to claims data for Japanese long-term care, for which the social insurance program has resulted in the emergence of a market that offers many care services for the elderly. The empirical results show that only 200 combinations of 14 at-home care services are used by more than 0.03% of the insured in Japan. Of these combinations, rehabilitation services have a considerable positive correlation with the health status of the elderly. However, their use is limited owing to regional disparities in the location of such services.

Suggested Citation

  • 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.
    • Handle: RePEc:spr:jecrev:v:73:y:2022:i:2:d:10.1007_s42973-019-00031-w
    DOI: 10.1007/s42973-019-00031-w
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s42973-019-00031-w
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s42973-019-00031-w?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
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Rong Fu & Haruko Noguchi, 2019. "Moral hazard under zero price policy: evidence from Japanese long-term care claims data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 785-799, August.
    2. 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.
    3. Kurimori, Sugako & Fukuda, Yoshiharu & Nakamura, Keiko & Watanabe, Masafumi & Takano, Takehito, 2006. "Calculation of prefectural disability-adjusted life expectancy (DALE) using long-term care prevalence and its socioeconomic correlates in Japan," Health Policy, Elsevier, vol. 76(3), pages 346-358, May.
    4. Noguchi, Haruko & Shimizutani, Satoshi, 2009. "Supplier density and at-home care use in Japan: Evidence from a micro-level survey on long-term care receivers," Japan and the World Economy, Elsevier, vol. 21(4), pages 365-372, December.
    5. 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.
    6. Bernard van den Berg & Ada Ferrer‐i‐Carbonell, 2007. "Monetary valuation of informal care: the well‐being valuation method," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1227-1244, November.
    7. Jing Guo & R. Tamara Konetzka & Willard G. Manning, 2015. "The Causal Effects of Home Care Use on Institutional Long‐Term Care Utilization and Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 4-17, March.
    8. Van Houtven, Courtney Harold & Coe, Norma B. & Skira, Meghan M., 2013. "The effect of informal care on work and wages," Journal of Health Economics, Elsevier, vol. 32(1), pages 240-252.
    9. 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.
    10. Norma B. Coe & Courtney Harold Van Houtven, 2009. "Caring for mom and neglecting yourself? The health effects of caring for an elderly parent," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 991-1010, September.
    11. Charles, Kerwin Kofi & Sevak, Purvi, 2005. "Can family caregiving substitute for nursing home care?," Journal of Health Economics, Elsevier, vol. 24(6), pages 1174-1190, November.
    12. Barry R. Chiswick, 1976. "The Demand for Nursing Home Care: An Analysis of the Substitution between Institutional and Noninstitutional Care," Journal of Human Resources, University of Wisconsin Press, vol. 11(3), pages 295-316.
    13. Jing Guo & R. Tamara Konetzka & Willard G. Manning, 2015. "The Causal Effects of Home Care Use on Institutional Long‐Term Care Utilization and Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 4-17, March.
    14. Heitmueller, Axel & Inglis, Kirsty, 2007. "The earnings of informal carers: Wage differentials and opportunity costs," Journal of Health Economics, Elsevier, vol. 26(4), pages 821-841, July.
    15. Sugawara, Shinya & Nakamura, Jiro, 2016. "Gatekeeper incentives and demand inducement: An empirical analysis of care managers in the Japanese long-term care insurance program," Journal of the Japanese and International Economies, Elsevier, vol. 40(C), pages 1-16.
    16. 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.
    17. 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.
    18. A. Belloni & V. Chernozhukov & I. Fernández‐Val & C. Hansen, 2017. "Program Evaluation and Causal Inference With High‐Dimensional Data," Econometrica, Econometric Society, vol. 85, pages 233-298, January.
    19. Sugawara, Shinya & Nakamura, Jiro, 2014. "Can formal elderly care stimulate female labor supply? The Japanese experience," Journal of the Japanese and International Economies, Elsevier, vol. 34(C), pages 98-115.
    20. Carmichael, Fiona & Charles, Sue, 1998. "The labour market costs of community care1," Journal of Health Economics, Elsevier, vol. 17(6), pages 747-765, December.
    21. Shinya Sugawara, 2017. "Firm‐Driven Management of Longevity Risk: Analysis of Lump‐Sum Forward Payments in Japanese Nursing Homes," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 26(1), pages 169-204, February.
    22. Izenman, Alan Julian, 1975. "Reduced-rank regression for the multivariate linear model," Journal of Multivariate Analysis, Elsevier, vol. 5(2), pages 248-264, June.
    23. Fu, Rong & Noguchi, Haruko & Kawamura, Akira & Takahashi, Hideto & Tamiya, Nanako, 2017. "Spillover effect of Japanese long-term care insurance as an employment promotion policy for family caregivers," Journal of Health Economics, Elsevier, vol. 56(C), pages 103-112.
    24. Heitmueller, Axel, 2007. "The chicken or the egg?: Endogeneity in labour market participation of informal carers in England," Journal of Health Economics, Elsevier, vol. 26(3), pages 536-559, May.
    25. Carmichael, Fiona & Charles, Susan, 2003. "The opportunity costs of informal care: does gender matter?," Journal of Health Economics, Elsevier, vol. 22(5), pages 781-803, September.
    26. 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.
    27. Sendhil Mullainathan & Jann Spiess, 2017. "Machine Learning: An Applied Econometric Approach," Journal of Economic Perspectives, American Economic Association, vol. 31(2), pages 87-106, Spring.
    28. Silvia Balia & Rinaldo Brau, 2014. "A Country For Old Men? Long‐Term Home Care Utilization In Europe," Health Economics, John Wiley & Sons, Ltd., vol. 23(10), pages 1185-1212, October.
    29. Claudine Meijer & Pieter Bakx & Eddy 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, pages 18-31, March.
    30. Olivia S Mitchell & John Piggott & Satoshi Shimizutani, 2008. "An Empirical Analysis of Patterns in the Japanese Long-Term Care Insurance System," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 33(4), pages 694-709, October.
    31. Ming Yuan & Yi Lin, 2006. "Model selection and estimation in regression with grouped variables," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 68(1), pages 49-67, February.
    Full references (including those not matched with items on IDEAS)

    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. 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.
    2. 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.
    3. Yoko Niimi, 2018. "Does providing informal elderly care hasten retirement? Evidence from Japan," Review of Development Economics, Wiley Blackwell, vol. 22(3), pages 1039-1062, August.
    4. Nishimura, Y.; Oikawa, M.;, 2017. "Effects of Informal Elderly Care on Labor Supply: Exploitation of Government Intervention on the Supply Side of Elderly Care Market," Health, Econometrics and Data Group (HEDG) Working Papers 17/02, HEDG, c/o Department of Economics, University of York.
    5. Niimi, Yoko, 2021. "Juggling paid work and elderly care provision in Japan: Does a flexible work environment help family caregivers cope?," Journal of the Japanese and International Economies, Elsevier, vol. 62(C).
    6. 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).
    7. 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.
    8. 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.
    9. 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.
    10. Matthias Firgo & Klaus Nowotny & Alexander Braun, 2017. "Austria 2025 – Informal, Formal, or Both? Assessing the Drivers of Home Care Utilisation in Austria Using a Simultaneous Decision Framework," WIFO Studies, WIFO, number 59741, February.
    11. Sugawara, Shinya & Nakamura, Jiro, 2014. "Can formal elderly care stimulate female labor supply? The Japanese experience," Journal of the Japanese and International Economies, Elsevier, vol. 34(C), pages 98-115.
    12. Rellstab, Sara & Bakx, Pieter & García-Gómez, Pilar & van Doorslaer, Eddy, 2020. "The kids are alright - labour market effects of unexpected parental hospitalisations in the Netherlands," Journal of Health Economics, Elsevier, vol. 69(C).
    13. Matthias Firgo & Klaus Nowotny & Alexander Braun, 2020. "Informal, formal, or both? Assessing the drivers of home care utilization in Austria using a simultaneous decision framework," Applied Economics, Taylor & Francis Journals, vol. 52(40), pages 4440-4456, August.
    14. 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).
    15. Mommaerts, Corina & Truskinovsky, Yulya, 2020. "The cyclicality of informal care," Journal of Health Economics, Elsevier, vol. 71(C).
    16. 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.
    17. Carrino, L.; & Nafilyan, V.; & Avendaño Pabon, M.;, 2019. "Should I Care or Should I Work? The Impact of Working in Older Age on Caregiving," Health, Econometrics and Data Group (HEDG) Working Papers 19/23, HEDG, c/o Department of Economics, University of York.
    18. Jacobs, Josephine C. & Van Houtven, Courtney H. & Laporte, Audrey & Coyte, Peter C., 2015. "Baby Boomer caregivers in the workforce: Do they fare better or worse than their predecessors?," The Journal of the Economics of Ageing, Elsevier, vol. 6(C), pages 89-101.
    19. Fischer, Björn & Müller, Kai-Uwe, 2020. "Time to care? The effects of retirement on informal care provision," Journal of Health Economics, Elsevier, vol. 73(C).
    20. 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.

    More about this item

    Keywords

    At-home elder care; Multiple care services; High-dimensional data; Basket analysis; Long-term care insurance in Japan;
    All these keywords.

    JEL classification:

    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    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:spr:jecrev:v:73:y:2022:i:2:d:10.1007_s42973-019-00031-w. 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 .

    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.