IDEAS home Printed from
   My bibliography  Save this article

The non-take up of long-term care benefit in France: A pecuniary motive?


  • Arrighi, Yves
  • Davin, Bérengère
  • Trannoy, Alain
  • Ventelou, Bruno


With aging populations, European countries face difficult challenges. In 2002, France implemented a public allowance program (APA) offering financial support to the disabled elderly for their long-term care (LTC) needs. Although currently granted to 1.2 million people, it is suspected that some of those eligible do not claim it—presenting a non-take-up behavior. The granting of APA is a decentralized process, with 94 County Councils (CC) managing it, with wide room for local interpretation. This spatial heterogeneity in the implementation of the program creates the conditions for a “quasi-natural experiment”, and provides the opportunity to study the demand for APA in relation to variations in CCs’ “generosity” in terms of both eligibility and subsidy rate for LTC. We use a national health survey and administrative data in a multilevel model controlling for geographical, cultural and political differences between counties. The results show that claiming for APA is associated with the “generosity” of CCs: the population tends to apply less for the allowance if the subsidy rate is in average lower. This pecuniary trade-off, revealed by our study, can have strong implications for the well-being of the elderly and their relatives.

Suggested Citation

  • 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.
  • Handle: RePEc:eee:hepoli:v:119:y:2015:i:10:p:1338-1348
    DOI: 10.1016/j.healthpol.2015.07.003

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

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

    Other versions of this item:

    References listed on IDEAS

    1. 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.
    2. Robert Schoeni & Mary Ofstedal, 2010. "Key themes in research on the demography of aging," Demography, Springer;Population Association of America (PAA), vol. 47(1), pages 5-15, March.
    3. Denis Kessler, 2008. "The Long-Term Care Insurance Market," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 33(1), pages 33-40, January.
    4. Sophie Guthmuller & Florence Jusot & Jérôme Wittwer, 2014. "Improving Takeup of Health Insurance Program: A Social Experiment in France," Journal of Human Resources, University of Wisconsin Press, vol. 49(1), pages 167-194.
    5. Olivier Bargain & Herwig Immervoll & Heikki Viitamäki, 2012. "No claim, no pain. Measuring the non-take-up of social assistance using register data," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 10(3), pages 375-395, September.
    6. Terza, Joseph V. & Basu, Anirban & Rathouz, Paul J., 2008. "Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling," Journal of Health Economics, Elsevier, vol. 27(3), pages 531-543, May.
    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. Riphahn, Regina T, 2001. "Rational Poverty or Poor Rationality? The Take-Up Study of Social Assistance Benefits," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 47(3), pages 379-398, September.
    9. repec:dau:papers:123456789/9715 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. 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.
    2. Quitterie Roquebert & Remi Kabore & Jerome Wittwer, 2018. "Decentralized policies and formal care use by the disabled elderly," PSE Working Papers halshs-01877829, HAL.
    3. Rudy Douven & Pieter Bakx & Frederik T. Schut, 2016. "Does independent needs assessment limit supply-side moral hazard in long-term care?," CPB Discussion Paper 327, CPB Netherlands Bureau for Economic Policy Analysis.


    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:eee:hepoli:v:119:y:2015:i:10:p:1338-1348. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu) or (). General contact details of provider: .

    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 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.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.