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

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

Abstract

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
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    1. 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.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    2. 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.
    3. Rapp, Thomas & Ronchetti, Jérome & Sicsic, Jonathan, 2022. "Impact of formal care consumption on informal care use in Europe: What is happening at the beginning of dependency?," Health Policy, Elsevier, vol. 126(7), pages 632-642.
    4. Bakx, Pieter & Douven, Rudy & Schut, Frederik T., 2021. "Does independent needs assessment limit use of publicly financed long-term care?," Health Policy, Elsevier, vol. 125(1), pages 41-46.
    5. Marianne Tenand, 2018. "Being dependent rather than handicapped in France: Does the institutional barrier at 60 affect care arrangements?," Working Papers halshs-01889452, HAL.
    6. 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.
    7. Quitterie Roquebert & Remi Kabore & Jerome Wittwer, 2018. "Decentralized policies and formal care use by the disabled elderly," Working Papers halshs-01877829, HAL.
    8. Sandrine Juin, 2016. "Care for dependent elderly people : dealing with health and financing issues," Erudite Ph.D Dissertations, Erudite, number ph16-02 edited by Thomas Barnay, December.
    9. Gyubeom Park & Kichan Yoon & Munjae Lee, 2021. "Regional Factors Influencing Non-Take-Up for Social Support in Korea Using a Spatial Regression Model," SAGE Open, , vol. 11(4), pages 21582440211, December.
    10. Marenzi, Anna & Rizzi, Dino & Zanette, Michele & Zantomio, Francesca, 2023. "Regional institutional quality and territorial equity in LTC provision," The Journal of the Economics of Ageing, Elsevier, vol. 26(C).
    11. 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.
    12. Andrea Barigazzi & Giovanni Gallo, 2023. "How Pandemic Shock Affects Claim for Minimum Income Measures," Center for the Analysis of Public Policies (CAPP) 0185, Universita di Modena e Reggio Emilia, Dipartimento di Economia "Marco Biagi".
    13. Marenzi, A.; & Rizzi, D.; & Zanette, M.; & Zantomio, F.;, 2022. "Regional Institutional Quality and Territorial Equity in LTC Provision," Health, Econometrics and Data Group (HEDG) Working Papers 22/27, HEDG, c/o Department of Economics, University of York.
    14. Sandrine Juin, 2019. "Formal home care, informal support and caregiver health: should other people care?," Erudite Working Paper 2019-21, Erudite.
    15. 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.
    16. 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.
    17. Stefano Boscolo & Giovanni Gallo, 2021. "The Struggle of Being Poor and Claimant: Evidence on the Non-Take-Up of Social Policies in Italy," Center for the Analysis of Public Policies (CAPP) 0174, Universita di Modena e Reggio Emilia, Dipartimento di Economia "Marco Biagi".
    18. Keane, Claire & Regan, Mark & Walsh, Brendan, 2021. "Failure to take-up public healthcare entitlements: Evidence from the Medical Card system in Ireland," Social Science & Medicine, Elsevier, vol. 281(C).
    19. 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.
    20. Enrica Croda & Jonathan Skinner & Laura Yasaitis, 2018. "The Health of Disability Insurance Enrollees: An International Comparison," Working Papers 2018:28, Department of Economics, University of Venice "Ca' Foscari".

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