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Demand for domestic help services: Evidence from a natural experiment

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  • Coulibaly, Siramane
  • Fortin, Bernard
  • Isabelle, Maripier

Abstract

We investigate how an increase in subsidies for purchasing domestic help services affects the consumption of individuals who need assistance to live at home. Drawing on administrative data, we analyse the impact of a reform implemented in Quebec (Canada) in 2016, which made the program more generous for a subgroup of beneficiaries. For this purpose, we estimate a difference-in-differences lognormal hurdle model. We derive the corresponding average treatment effect on the treated for this class of non-linear models. Our results suggest that the price elasticity of the demand for subsidized domestic help services for the treated is around 0.74. The elasticity of monthly purchase frequency (0.59) is much larger than the elasticity of monthly purchase intensity (0.14). Based on our results, we determine a floor to the marginal external benefit required for the reform to be socially worth adopting.

Suggested Citation

  • Coulibaly, Siramane & Fortin, Bernard & Isabelle, Maripier, 2025. "Demand for domestic help services: Evidence from a natural experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 238(C).
    • Handle: RePEc:eee:jeborg:v:238:y:2025:i:c:s0167268125003531
    DOI: 10.1016/j.jebo.2025.107234
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    1. Bruce D. Meyer & Nikolas Mittag, 2019. "Using Linked Survey and Administrative Data to Better Measure Income: Implications for Poverty, Program Effectiveness, and Holes in the Safety Net," American Economic Journal: Applied Economics, American Economic Association, vol. 11(2), pages 176-204, April.
    2. Deaton, Angus & Irish, Margaret, 1984. "Statistical models for zero expenditures in household budgets," Journal of Public Economics, Elsevier, vol. 23(1-2), pages 59-80.
    3. Gerard J. van den Berg & Antoine Bozio & Mónica Costa Dias, 2020. "Policy discontinuity and duration outcomes," Quantitative Economics, Econometric Society, vol. 11(3), pages 871-916, July.
    4. Jing Guo & R. Tamara Konetzka & Willard G. Manning, 2015. "The Causal Effects of Home Care Use on Institutional Long‐Term Care Utilization and Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 4-17, March.
    5. 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.
    6. Achou, Bertrand & De Donder, Philippe & Glenzer, Franca & Lee, Minjoon & Leroux, Marie-Louise, 2026. "At home versus in a nursing home: Long-term care settings and marginal utility," Journal of Economic Dynamics and Control, Elsevier, vol. 183(C).
    7. Bound, John & Brown, Charles & Mathiowetz, Nancy, 2001. "Measurement error in survey data," Handbook of Econometrics, in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 5, chapter 59, pages 3705-3843, Elsevier.
    8. Shen, Karen, 2024. "Who benefits from public financing of home-based long term care? Evidence from Medicaid," Journal of Public Economics, Elsevier, vol. 236(C).
    9. 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.
    10. Kevin S. Milligan & Tammy Schirle, 2023. "The Economics of Long-Term Care in Canada," NBER Working Papers 31875, National Bureau of Economic Research, Inc.
    11. Vuong, Quang H, 1989. "Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses," Econometrica, Econometric Society, vol. 57(2), pages 307-333, March.
    12. O'Neill, June A & Bassi, Laurie J & Wolf, Douglas A, 1987. "The Duration of Welfare Spells," The Review of Economics and Statistics, MIT Press, vol. 69(2), pages 241-248, May.
    13. 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.
    14. Costa-Font, Joan & Jimenez-Martin, Sergi & Vilaplana, Cristina, 2018. "Does long-term care subsidization reduce hospital admissions and utilization?," Journal of Health Economics, Elsevier, vol. 58(C), pages 43-66.
    15. Cragg, John G, 1971. "Some Statistical Models for Limited Dependent Variables with Application to the Demand for Durable Goods," Econometrica, Econometric Society, vol. 39(5), pages 829-844, September.
    16. Achou, Bertrand & De Donder, Philippe & Glenzer, Franca & Lee, Minjoon & Leroux, Marie-Louise, 2022. "Nursing home aversion post-pandemic: Implications for savings and long-term care policy," Journal of Economic Behavior & Organization, Elsevier, vol. 201(C), pages 1-21.
    17. McKnight, Robin, 2006. "Home care reimbursement, long-term care utilization, and health outcomes," Journal of Public Economics, Elsevier, vol. 90(1-2), pages 293-323, January.
    18. 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.
    19. Jonathan Gruber & Kathleen McGarry, 2025. "Long-Term Care around the World," NBER Books, National Bureau of Economic Research, Inc, number mcga-1, August.
    20. 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.
    21. Richard Blundell & Alan Duncan & Costas Meghir, 1998. "Estimating Labor Supply Responses Using Tax Reforms," Econometrica, Econometric Society, vol. 66(4), pages 827-862, July.
    22. Jing Guo & R. Tamara Konetzka & Willard G. Manning, 2015. "The Causal Effects of Home Care Use on Institutional Long‐Term Care Utilization and Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 4-17, March.
    23. Susan Athey & Guido W. Imbens, 2006. "Identification and Inference in Nonlinear Difference-in-Differences Models," Econometrica, Econometric Society, vol. 74(2), pages 431-497, March.
    24. Sarma, Sisira & Hawley, Gordon & Basu, Kisalaya, 2009. "Transitions in living arrangements of Canadian seniors: Findings from the NPHS longitudinal data," Social Science & Medicine, Elsevier, vol. 68(6), pages 1106-1113, March.
    25. Fabrizio Carlevaro & Yves Croissant, 2023. "Hurdle Regression Models: An Application to Consumer Behavior in the United States," Contributions to Economics, in: Deep Mukherjee (ed.), Applied Econometric Analysis Using Cross Section and Panel Data, chapter 0, pages 227-268, Springer.
    26. Nada Eissa & Jeffrey B. Liebman, 1996. "Labor Supply Response to the Earned Income Tax Credit," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 605-637.
    27. Hoerger, Thomas J & Picone, Gabriel A & Sloan, Frank A, 1996. "Public Subsidies, Private Provision of Care and Living Arrangements of the Elderly," The Review of Economics and Statistics, MIT Press, vol. 78(3), pages 428-440, August.
    28. 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.
    29. 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.
    30. Kim, Hyuncheol Bryant & Lim, Wilfredo, 2015. "Long-term care insurance, informal care, and medical expenditures," Journal of Public Economics, Elsevier, vol. 125(C), pages 128-142.
    31. Puhani, Patrick A., 2012. "The treatment effect, the cross difference, and the interaction term in nonlinear “difference-in-differences” models," Economics Letters, Elsevier, vol. 115(1), pages 85-87.
    32. Naoko Muramatsu & Hongjun Yin & Richard T. Campbell & Ruby L. Hoyem & Martha A. Jacob & Christopher O. Ross, 2007. "Risk of Nursing Home Admission Among Older Americans: Does States' Spending on Home- and Community-Based Services Matter?," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 62(3), pages 169-178.
    33. Maaike Diepstraten & Rudy Douven & Bram Wouterse, 2020. "Can your house keep you out of a nursing home?," Health Economics, John Wiley & Sons, Ltd., vol. 29(5), pages 540-553, May.
    34. Sarma, Sisira & Simpson, Wayne, 2007. "A panel multinomial logit analysis of elderly living arrangements: Evidence from aging in Manitoba longitudinal data, Canada," Social Science & Medicine, Elsevier, vol. 65(12), pages 2539-2552, December.
    35. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, December.
    36. Orsini, Chiara, 2010. "Changing the way the elderly live: Evidence from the home health care market in the United States," Journal of Public Economics, Elsevier, vol. 94(1-2), pages 142-152, February.
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    JEL classification:

    • H20 - Public Economics - - Taxation, Subsidies, and Revenue - - - General
    • H31 - Public Economics - - Fiscal Policies and Behavior of Economic Agents - - - Household
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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