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Does public long-term care expenditure improve care-related quality of life in England?

Author

Listed:
  • Francesco Longo

    (Centre for Health Economics, University of York, York, UK)

  • Karl Claxton

    (Centre for Health Economics, Department of Economics and Related Studies University of York, York, UK)

  • James Lomas

    (Centre for Health Economics, University of York, York, UK)

  • Stephen Martin

    (Department of Economics and Related Studies, University of York, UK)

Abstract

Public long-term care (LTC) systems are common across Organisation for Economic Co-operation and Development countries and they provide services to support people experiencing difficulties with their activities of daily living. This study investigates the marginal effect of changes in public LTC expenditure on care-related quality of life (CRQoL) in England. The public LTC programme for people aged 18 or older in England is called Adult Social Care (ASC) and it is provided and managed by local authorities. We collect data on outcomes and characteristics of public ASC users, and on public ASC expenditure and characteristics of local authorities across England in 2017/18. We employ an instrumental variable approach using conditionally exogenous elements of the public funding system to estimate the effect of public ASC expenditure on users’ CRQoL. Our findings show that increasing public ASC expenditure by £1,000 per user generates 0.0031 additional CRQoL. These results suggest that public ASC is effective in increasing users’ quality of life but only to a relatively small extent. Combined with other findings on the effect of LTC expenditure on mortality, this study can inform policy makers in the UK and around the world about whether social care provides good value for money.

Suggested Citation

  • Francesco Longo & Karl Claxton & James Lomas & Stephen Martin, 2020. "Does public long-term care expenditure improve care-related quality of life in England?," Working Papers 172cherp, Centre for Health Economics, University of York.
  • Handle: RePEc:chy:respap:172cherp
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    as
    1. Adrian Adermon & Mikael Lindahl & Daniel Waldenström, 2018. "Intergenerational Wealth Mobility and the Role of Inheritance: Evidence from Multiple Generations," Economic Journal, Royal Economic Society, vol. 128(612), pages 482-513, July.
    2. Karl Claxton & James Lomas & Stephen Martin, 2018. "The impact of NHS expenditure on health outcomes in England: Alternative approaches to identification in all‐cause and disease specific models of mortality," Health Economics, John Wiley & Sons, Ltd., vol. 27(6), pages 1017-1023, June.
    3. Mansour Farahani & S. V. Subramanian & David Canning, 2010. "Effects of state‐level public spending on health on the mortality probability in India," Health Economics, John Wiley & Sons, Ltd., vol. 19(11), pages 1361-1376, November.
    4. Jacobs,Rowena & Smith,Peter C. & Street,Andrew, 2006. "Measuring Efficiency in Health Care," Cambridge Books, Cambridge University Press, number 9780521851442.
    5. Gary S. Becker, 1981. "A Treatise on the Family," NBER Books, National Bureau of Economic Research, Inc, number beck81-1, March.
    6. Compton, Janice & Pollak, Robert A., 2014. "Family proximity, childcare, and women’s labor force attachment," Journal of Urban Economics, Elsevier, vol. 79(C), pages 72-90.
    7. Martyn Andrews & Obbey Elamin & Alastair R. Hall & Kostas Kyriakoulis & Matthew Sutton, 2017. "Inference in the presence of redundant moment conditions and the impact of government health expenditure on health outcomes in England," Econometric Reviews, Taylor & Francis Journals, vol. 36(1-3), pages 23-41, March.
    8. Linda Datcher Loury, 2006. "All in the Extended Family: Effects of Grandparents, Aunts, and Uncles on Educational Attainment," American Economic Review, American Economic Association, vol. 96(2), pages 275-278, May.
    9. Gigliotti, Philip & Sorensen, Lucy C., 2018. "Educational resources and student achievement: Evidence from the Save Harmless provision in New York State," Economics of Education Review, Elsevier, vol. 66(C), pages 167-182.
    10. Joshua Hyman, 2017. "Does Money Matter in the Long Run? Effects of School Spending on Educational Attainment," American Economic Journal: Economic Policy, American Economic Association, vol. 9(4), pages 256-280, November.
    11. Julien Forder & Katerina Gousia & Eirini-Christina Saloniki, 2019. "The impact of long-term care on primary care doctor consultations for people over 75 years," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 375-387, April.
    12. 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.
    13. Barbara Lipszyc & Etienne Sail & Ana Xavier, 2012. "Long-term care: need, use and expenditure in the EU-27," European Economy - Economic Papers 2008 - 2015 469, Directorate General Economic and Financial Affairs (DG ECFIN), European Commission.
    14. Goodspeed, Timothy J., 2000. "Tax structure in a federation," Journal of Public Economics, Elsevier, vol. 75(3), pages 493-506, March.
    15. Linda Loury, 2006. "All in the Extended Family: Grandparents, Aunts, and Uncles and Educational Attainment," Discussion Papers Series, Department of Economics, Tufts University 0618, Department of Economics, Tufts University.
    16. van Leeuwen, K.M. & Malley, J. & Bosmans, J.E. & Jansen, A.P.D. & Ostelo, R.W. & van der Horst, H.E. & Netten, A., 2014. "What can local authorities do to improve the social care-related quality of life of older adults living at home?: evidence from the adult social care survey," LSE Research Online Documents on Economics 58022, London School of Economics and Political Science, LSE Library.
    17. Hægeland, Torbjørn & Raaum, Oddbjørn & Salvanes, Kjell G., 2012. "Pennies from heaven? Using exogenous tax variation to identify effects of school resources on pupil achievement," Economics of Education Review, Elsevier, vol. 31(5), pages 601-614.
    18. Jonathan Siverskog & Martin Henriksson, 2019. "Estimating the marginal cost of a life year in Sweden’s public healthcare sector," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 751-762, July.
    19. Sonia Bhalotra, 2007. "Spending to save? State health expenditure and infant mortality in India," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 911-928, September.
    20. Jose-Luis Fernandez & J. Forder, 2008. "Consequences of local variations in social care on the performance of the acute health care sector," Applied Economics, Taylor & Francis Journals, vol. 40(12), pages 1503-1518.
    21. Julien Forder & Juliette Malley & Ann‐Marie Towers & Ann Netten, 2014. "Using Cost‐Effectiveness Estimates From Survey Data To Guide Commissioning: An Application To Home Care," Health Economics, John Wiley & Sons, Ltd., vol. 23(8), pages 979-992, August.
    22. Julien Forder, 2009. "Long‐term care and hospital utilisation by older people: an analysis of substitution rates," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1322-1338, November.
    23. Rhee, Jong Chul & Done, Nicolae & Anderson, Gerard F., 2015. "Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany," Health Policy, Elsevier, vol. 119(10), pages 1319-1329.
    24. Amy Finkelstein & Kathleen McGarry, 2006. "Multiple Dimensions of Private Information: Evidence from the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 96(4), pages 938-958, September.
    25. Linda Loury, 2006. "All in the Extended Family: Grandparents, Aunts, and Uncles and Educational Attainment," Discussion Papers Series, Department of Economics, Tufts University 0610, Department of Economics, Tufts University.
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    More about this item

    Keywords

    long-term care; marginal productivity; quality of life; public expenditure; cross-section; instrumental variables.;
    All these keywords.

    JEL classification:

    • H53 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Welfare Programs
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation

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