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Pay less, consume more? Estimating the price elasticity of demand for home care services of the disabled elderly

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  • Roquebert, Q.
  • Tenand, M.

Abstract

Although the consumption of home care is increasing with population ageing, little is known about its price sensitivity. This paper estimates the price elasticity of the demand for home care of the disabled elderly, using the French home care subsidy program ("APA"). We use an original dataset collected from a French District Council with administrative records of APA out-of-pocket payments and home care consumption. Identification primarily relies on inter-individual variations in producer prices. We use the unequal spatial distribution of producers to address the potential price endogeneity arising from non-random selection into a producer. Our results point to a price elasticity around -0.4: a 10% increase in the out-of-pocket price is predicted to lower consumption by 4%, or 37 minutes per month for the median consumer. Copayment rates thus matter for allocative and dynamic efficiencies, while the generosity of home care subsidies also entails redistributive effects.

Suggested Citation

  • Roquebert, Q. & Tenand, M., 2016. "Pay less, consume more? Estimating the price elasticity of demand for home care services of the disabled elderly," Health, Econometrics and Data Group (HEDG) Working Papers 16/16, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:16/16
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    1. Pieter Bakx & Claudine de Meijer & Frederik Schut & Eddy van Doorslaer, 2015. "Going Formal or Informal, Who Cares? The Influence of Public Long‐Term Care Insurance," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 631-643, June.
    2. 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.
    3. Tarja Viitanen, 2007. "Informal And Formal Care In Europe," Working Papers 2007010, The University of Sheffield, Department of Economics, revised Jun 2007.
    4. 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.
    5. Honore, Bo E, 1992. "Trimmed LAD and Least Squares Estimation of Truncated and Censored Regression Models with Fixed Effects," Econometrica, Econometric Society, vol. 60(3), pages 533-565, May.
    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. 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.
    8. Khan, Shakeeb & Tamer, Elie, 2009. "Inference on endogenously censored regression models using conditional moment inequalities," Journal of Econometrics, Elsevier, vol. 152(2), pages 104-119, October.
    9. 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.
    10. 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.
    11. Jeffrey R. Brown & Amy Finkelstein, 2009. "The Private Market for Long‐Term Care Insurance in the United States: A Review of the Evidence," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 76(1), pages 5-29, March.
    12. 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.
    13. David Bardey & Agnès Couffinhal & Michel Grignon, 2003. "Efficacité et risque moral ex post en assurance maladie," Revue Française d'Économie, Programme National Persée, vol. 18(2), pages 165-197.
    14. Pierre-Yves Geoffard, 2000. "Dépenses de santé : l'hypothèse d'aléa moral," Économie et Prévision, Programme National Persée, vol. 142(1), pages 123-135.
    15. 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.
    16. 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.
    17. 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.
    18. 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.
    19. 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.
    20. 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.
    21. de Meijer, Claudine & Koopmanschap, Marc & d' Uva, Teresa Bago & van Doorslaer, Eddy, 2011. "Determinants of long-term care spending: Age, time to death or disability?," Journal of Health Economics, Elsevier, vol. 30(2), pages 425-438, March.
    22. 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.
    23. Eichner, Matthew J, 1998. "The Demand for Medical Care: What People Pay Does Matter," American Economic Review, American Economic Association, vol. 88(2), pages 117-121, May.
    24. 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.
    25. 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.
    26. Duarte, Fabian, 2012. "Price elasticity of expenditure across health care services," Journal of Health Economics, Elsevier, vol. 31(6), pages 824-841.
    27. Moffitt, Robert, 1990. "The Econometrics of Kinked Budget Constraints," Journal of Economic Perspectives, American Economic Association, vol. 4(2), pages 119-139, Spring.
    28. 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.
    29. Nyman, John A., 1999. "The economics of moral hazard revisited," Journal of Health Economics, Elsevier, vol. 18(6), pages 811-824, December.
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    More about this item

    Keywords

    long-term care; price elasticity; public policy;
    All these keywords.

    JEL classification:

    • C24 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Truncated and Censored Models; Switching Regression Models; Threshold Regression Models
    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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