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Pay less, consume more? The price elasticity of home care for the disabled elderly in France

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  • Quitterie Roquebert
  • Marianne Tenand

Abstract

Little is known about the price sensitivity of demand for home care of the disabled elderly. We partially fill this knowledge gap by using administrative data on the beneficiaries of the main French home care subsidy program in a department and exploiting interindividual variation in provider prices. We address the potential endogeneity of prices by taking advantage of the unequal spatial coverage of providers and instrumenting price by the number of municipalities served by a provider. We estimate a price elasticity of around −0.4 that is significantly different from both 0 and −1. This less than proportionate response of consumption to price has implications for the efficiency and redistributive impact of variation in the level of copayments in home care subsidy schemes.

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  • Quitterie Roquebert & Marianne Tenand, 2017. "Pay less, consume more? The price elasticity of home care for the disabled elderly in France," Health Economics, John Wiley & Sons, Ltd., vol. 26(9), pages 1162-1174, September.
    • Handle: RePEc:wly:hlthec:v:26:y:2017:i:9:p:1162-1174
    DOI: 10.1002/hec.3531
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    1. Cécile Bourreau-Dubois & Agnès Gramain & Helen Lim & Jingyue Xing, 2014. "Impact du reste à charge sur le volume d'heures d'aide à domicile utilisé par les bénéficiaires de l'APA," Documents de travail du Centre d'Economie de la Sorbonne 14024, Université Panthéon-Sorbonne (Paris 1), Centre d'Economie de la Sorbonne.
    2. Aviva Aron-Dine & Liran Einav & Amy Finkelstein, 2013. "The RAND Health Insurance Experiment, Three Decades Later," Journal of Economic Perspectives, American Economic Association, vol. 27(1), pages 197-222, Winter.
    3. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    4. Raj Chetty & Adam Looney & Kory Kroft, 2009. "Salience and Taxation: Theory and Evidence," American Economic Review, American Economic Association, vol. 99(4), pages 1145-1177, September.
    5. Cécile Bourreau-Dubois & Quitterie Roquebert & Agnès Gramain, 2015. "Les disparités départementales dans la mise en oeuvre de l’APA à domicile, reflets des choix de politiques locales ?," Post-Print hal-01158419, HAL.
    6. Liliana E. Pezzin & Peter Kemper & James Reschovsky, 1996. "Does Publicly Provided Home Care Substitute for Family Care? Experimental Evidence with Endogenous Living Arrangements," Journal of Human Resources, University of Wisconsin Press, vol. 31(3), pages 650-676.
    7. Moffitt, Robert, 1986. "The Econometrics of Piecewise-Linear Budget Constraints: A Survey and Exposition of the Maximum Likelihood Method," Journal of Business & Economic Statistics, American Statistical Association, vol. 4(3), pages 317-328, July.
    8. Roméo Fontaine, 2012. "The Effect of Public Subsidies for Formal Care on the Care Provision for Disabled Elderly People in France," Post-Print halshs-01227866, HAL.
    9. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
    10. 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.
    11. Stabile, Mark & Laporte, Audrey & Coyte, Peter C., 2006. "Household responses to public home care programs," Journal of Health Economics, Elsevier, vol. 25(4), pages 674-701, July.
    12. Ettner, Susan L, 1994. "The Effect of the Medicaid Home Care Benefit on Long-Term Care Choices of the Elderly," Economic Inquiry, Western Economic Association International, vol. 32(1), pages 103-127, January.
    13. Agnès Gramain & Jingyue Xing, 2012. "Tarification publique et normalisation des processus de production dans le secteur de l'aide à domicile pour les personnes âgées," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) hal-00763762, HAL.
    14. Cutler, David M. & Zeckhauser, Richard J., 2000. "The anatomy of health insurance," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 11, pages 563-643, Elsevier.
    15. 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.
    16. A. Colin Cameron & Douglas L. Miller, 2015. "A Practitioner’s Guide to Cluster-Robust Inference," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 317-372.
    17. Arrighi, Yves & Davin, Bérengère & Trannoy, Alain & Ventelou, Bruno, 2015. "The non-take up of long-term care benefit in France: A pecuniary motive?," Health Policy, Elsevier, vol. 119(10), pages 1338-1348.
    18. Zeckhauser, Richard, 1970. "Medical insurance: A case study of the tradeoff between risk spreading and appropriate incentives," Journal of Economic Theory, Elsevier, vol. 2(1), pages 10-26, March.
    19. Pierre-Yves Geoffard, 2000. "Dépenses de santé : l'hypothèse d'aléa moral," Économie et Prévision, Programme National Persée, vol. 142(1), pages 123-135.
    20. Rapp, Thomas & Chauvin, Pauline & Sirven, Nicolas, 2015. "Are public subsidies effective to reduce emergency care? Evidence from the PLASA study," Social Science & Medicine, Elsevier, vol. 138(C), pages 31-37.
    21. 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.
    22. Duarte, Fabian, 2012. "Price elasticity of expenditure across health care services," Journal of Health Economics, Elsevier, vol. 31(6), pages 824-841.
    23. 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.
    24. 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.
    25. Robin Hege & Quitterie Roquebert & Marianne Tenand, 2014. "La tarification des services d'aide à domicile : un outil au service des politiques départementales ?," Post-Print hal-01092496, HAL.
    26. Chen Zhen & Eric A. Finkelstein & James M. Nonnemaker & Shawn A. Karns & Jessica E. Todd, 2014. "Predicting the Effects of Sugar-Sweetened Beverage Taxes on Food and Beverage Demand in a Large Demand System," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 96(1), pages 1-25.
    27. Barnay, Thomas & Juin, Sandrine, 2016. "Does home care for dependent elderly people improve their mental health?," Journal of Health Economics, Elsevier, vol. 45(C), pages 149-160.
    28. Fukushima, Kazuya & Mizuoka, Sou & Yamamoto, Shunsuke & Iizuka, Toshiaki, 2016. "Patient cost sharing and medical expenditures for the Elderly," Journal of Health Economics, Elsevier, vol. 45(C), pages 115-130.
    29. Moffitt, Robert, 1990. "The Econometrics of Kinked Budget Constraints," Journal of Economic Perspectives, American Economic Association, vol. 4(2), pages 119-139, Spring.
    30. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
    31. Agnès Gramain & Solène Billaud & Cécile Bourreau-Dubois & Helen Lim & Florence Weber & Jingyue Xing, 2012. "La prise en charge de la dépendance des personnes âgées: les dimensions territoriales de l'action publique," Working Papers halshs-00705569, HAL.
    32. Moulton, Brent R, 1990. "An Illustration of a Pitfall in Estimating the Effects of Aggregate Variables on Micro Unit," The Review of Economics and Statistics, MIT Press, vol. 72(2), pages 334-338, May.
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    Cited by:

    1. Liu, Hong & Ma, Jinqiu & Zhao, Liqiu, 2023. "Public long-term care insurance and consumption of elderly households: Evidence from China," Journal of Health Economics, Elsevier, vol. 90(C).
    2. Marianne Tenand, 2018. "Being dependent rather than handicapped in France: Does the institutional barrier at 60 affect care arrangements?," PSE Working Papers halshs-01889452, HAL.
    3. Quitterie Roquebert & Jonathan Sicsic & Thomas Rapp, 2021. "Health measures and long-term care use in the European frail population," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(3), pages 405-423, April.
    4. Elsa Perdrix & Quitterie Roquebert, 2022. "Does the amount of formal care affect informal care? Evidence among over-60s in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(3), pages 453-465, April.
    5. Øystein Hernæs & Snorre Kverndokk & Simen Markussen & Henning Øien, 2023. "When Health Trumps Money: Economic Incentives and Health Equity in the Provision of Nursing Homes," CESifo Working Paper Series 10359, CESifo.
    6. Hernæs, Øystein & Kverndokk, Snorre & Markussen, Simen & Øien, Henning, 2023. "When health trumps money: Economic incentives and health equity in the public provision of nursing homes in Norway," Social Science & Medicine, Elsevier, vol. 333(C).
    7. Marielle Non, 2017. "Co-payments in long-term home care: do they affect the use of care?," CPB Discussion Paper 363, CPB Netherlands Bureau for Economic Policy Analysis.
    8. SeungHoon Han & Hosung Sohn, 2023. "The short-term effects of fixed copayment policy on elderly health spending and service utilization: evidence from South Korea’s age-based policy using exact date of birth," International Journal of Health Economics and Management, Springer, vol. 23(2), pages 255-279, June.
    9. Quitterie Roquebert & Remi Kabore & Jerome Wittwer, 2018. "Decentralized policies and formal care use by the disabled elderly," Working Papers halshs-01877829, HAL.
    10. Marielle Non, 2017. "Co-payments in long-term home care: do they affect the use of care?," CPB Discussion Paper 363.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    11. Keane, Claire & Seán Lyons & Mark Regan & Walsh, Brendan, 2022. "Home support services in Ireland: Exchequer and distributional impacts of funding options," Research Series, Economic and Social Research Institute (ESRI), number SUSTAT111, June.
    12. Sano, Kazuaki & Miyawaki, Atsushi & Abe, Kazuhiro & Jin, Xueying & Watanabe, Taeko & Tamiya, Nanako & Kobayashi, Yasuki, 2022. "Effects of cost sharing on long-term care service utilization among home-dwelling older adults in Japan," Health Policy, Elsevier, vol. 126(12), pages 1310-1316.
    13. Elsa Perdrix & Quitterie Roquebert, 2020. "Does an increase in formal care affect informal care ? Evidence among the French elderly," PSE Working Papers halshs-02370689, HAL.
    14. Marianne Tenand & Pieter Bakx & Eddy van Doorslaer, 2020. "Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 435-451, April.
    15. Marianne Tenand & Pieter Bakx & Eddy van Doorslaer, 2020. "Eligibility or use? Disentangling the sources of horizontal inequity in home care receipt in the Netherlands," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1161-1179, October.
    16. Marianne Tenand & Pieter Bakx & Bram Wouterse, 2021. "The impact of co-payments for nursing home care on use, health, and welfare," CPB Discussion Paper 430, CPB Netherlands Bureau for Economic Policy Analysis.

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