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Unravelling Hidden Inequities in a Universal Public Long-Term Care System

Author

Listed:
  • Pilar (P.) Garcia-Gomez

    (Erasmus University Rotterdam)

  • Helena M Hernandez-Pizarro

    (Universitat Pompeu Fabra)

  • Guillem Lopez-Casasnovas

    (Universitat Pompeu Fabra)

  • Joaquim Vidiella-Martin

    (Erasmus University Rotterdam)

Abstract

We investigate whether publicly subsidized long-term care (LTC) is allocated according to needs, independently from income, using administrative data from all applicants for public LTC in Catalonia, from 2011 to 2014. We measure the level of horizontal inequity in subsidies to compensate informal care costs, formal home care, and institutional care using objective detailed information on needs. Our findings suggest that the system is inequitable; cash transfers are distributed among the financially better-off, while the use of nursing homes is concentrated among the worse-off. Additionally, we assess the inequity in the form of provision (voucher versus in- kind) and its implications for the equity in the time to access. Our results show that while in-kind provision is concentrated among the worse-off, the better-off are more likely to receive a voucher to (partly) subsidize LTC expenses. However, this duality does not imply inequity in the time to access a nursing home.

Suggested Citation

  • Pilar (P.) Garcia-Gomez & Helena M Hernandez-Pizarro & Guillem Lopez-Casasnovas & Joaquim Vidiella-Martin, 2019. "Unravelling Hidden Inequities in a Universal Public Long-Term Care System," Tinbergen Institute Discussion Papers 19-011/V, Tinbergen Institute.
    • Handle: RePEc:tin:wpaper:20190011
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    References listed on IDEAS

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    More about this item

    Keywords

    long-term care; equity; public provision; voucher; in-kind;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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