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Optimal public provision of nursing homes and the role of information

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  • Kuhn, Michael
  • Nuscheler, Robert

Abstract

Abstract Increasing demand for long-term care poses at least five challenges to the policy-maker: (i) How should care be supplied, within a nursing home or within the family? (ii) What level of care should be provided in the different arrangements? (iii) How do the answers relate to the severity of dependence? (iv) How can financial strain be mitigated for families with severely dependent members? (v) What is the role of information constraints for the nature and scope of optimal long-term care policy? We consider a theoretical model of long-term care provision under adverse selection to address these challenges. Our main - and remarkably robust - result is that nursing home care facilitates self selection and mitigates and possibly eliminates distortions in caring levels and transfers. Informational asymmetries may thus lead to care being provided too often within institutions rather than within a family context.

Suggested Citation

  • Kuhn, Michael & Nuscheler, Robert, 2011. "Optimal public provision of nursing homes and the role of information," Journal of Health Economics, Elsevier, vol. 30(4), pages 795-810, July.
  • Handle: RePEc:eee:jhecon:v:30:y:2011:i:4:p:795-810
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    Cited by:

    1. Nuscheler, Robert & Roeder, Kerstin, 2013. "The political economy of long-term care," European Economic Review, Elsevier, vol. 62(C), pages 154-173.
    2. Chiara Canta & Pierre Pestieau & Emmanuel Thibault, 2016. "Long-term care and capital accumulation: the impact of the State, the market and the family," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 61(4), pages 755-785, April.
    3. Elena Gentili & Giuliano Masiero & Fabrizio Mazzonna, 2016. "The Role of Culture in Long-term Care," IdEP Economic Papers 1605, USI Università della Svizzera italiana.
    4. Siciliani Luigi, 2013. "The Economics of Long-Term Care," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 14(2), pages 343-375, August.
    5. Fevang, Elisabeth & Kverndokk, Snorre & Røed, Knut, 2009. "A model for supply of informal care to elderly parents," HERO On line Working Paper Series 2008:12, Oslo University, Health Economics Research Programme.
    6. repec:eee:jeborg:v:143:y:2017:i:c:p:186-200 is not listed on IDEAS
    7. Fevang, Elisabeth & Kverndokk, Snorre & Røed, Knut, 2008. "Informal Care and Labor Supply," IZA Discussion Papers 3717, Institute for the Study of Labor (IZA).
    8. Ziebarth, Nicolas R., 2017. "Social Insurance and Health," IZA Discussion Papers 10918, Institute for the Study of Labor (IZA).
    9. Sergi Jiménez-Martín & Cristina Vilaplana Prieto, 2013. "Informal Care and intergenerational transfers in European Countries," Working Papers 2013-25, FEDEA.
    10. Joan Costa‐Font & Edward C. Norton & Luigi Siciliani & James Gaughan & Hugh Gravelle & Luigi Siciliani, 2017. "Delayed Discharges and Hospital Type: Evidence from the English NHS," Fiscal Studies, Institute for Fiscal Studies, vol. 38, pages 495-519, September.
    11. Jakobsson, Niklas & Kotsadam, Andreas & Syse, Astri & Øien, Henning, 2016. "Gender bias in public long-term care? A survey experiment among care managers," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 126-138.
    12. Elisabeth Fevang & Snorre Kverndokk & Knut Røed, 2012. "Labor supply in the terminal stages of lone parents’ lives," Journal of Population Economics, Springer;European Society for Population Economics, vol. 25(4), pages 1399-1422, October.

    More about this item

    Keywords

    D82 H23 I18 J14 Adverse selection Long-term care Nursing homes Redistribution;

    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • H23 - Public Economics - - Taxation, Subsidies, and Revenue - - - Externalities; Redistributive Effects; Environmental Taxes and Subsidies
    • 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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