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The impact of long-term care on primary care doctor consultations for people over 75 years

Author

Listed:
  • Julien Forder

    (University of Kent)

  • Katerina Gousia

    (University of Kent
    University of Kent)

  • Eirini-Christina Saloniki

    (University of Kent
    University of Kent)

Abstract

Many countries are adopting policies to create greater coordination and integration between acute and long-term care services. This policy is predicated on the assumption that these service areas have interdependent outcomes for patients. In this paper, we study the interdependencies between the long-term (home care) services and consultations with a primary care doctor, as used by people over 75 years. Starting with a model of individual’s demand for doctor consultations, given supply, we formalize the hypothesis that exogenous increases to home care supply will reduce the number of consultations where these services are technical substitutes. Furthermore, greater coordination of public service planning and use of pooled budgets could lead to better outcomes because planners can account for these externalities. We test our main hypothesis using data from the British Household Panel Study for 1991–2009. To address potential concerns about endogeneity, we use a set of instrumental variables for home care motivated by institutional features of the social care system. We find that there is a statistically significant substitution effect between home care and doctor visits, which is robust across a range of specifications. This result has implications for policies that consider increased coordination between health care and social care systems.

Suggested Citation

  • Julien Forder & Katerina Gousia & Eirini-Christina Saloniki, 2019. "The impact of long-term care on primary care doctor consultations for people over 75 years," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 375-387, April.
    • Handle: RePEc:spr:eujhec:v:20:y:2019:i:3:d:10.1007_s10198-018-0999-6
    DOI: 10.1007/s10198-018-0999-6
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    Cited by:

    1. Brendan Walsh & Seán Lyons & Samantha Smith & Maev‐Ann Wren & James Eighan & Edgar Morgenroth, 2020. "Does formal home care reduce inpatient length of stay?," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1620-1636, December.
    2. Francesco Longo & Karl Claxton & Stephen Martin & James Lomas, 2023. "More long‐term care for better healthcare and vice versa: investigating the mortality effects of interactions between these public sectors," Fiscal Studies, John Wiley & Sons, vol. 44(2), pages 189-216, June.
    3. Wang, Yixiao & Yang, Wei & Avendano, Mauricio, 2022. "Does informal care reduce health care utilisation in older age? Evidence from China," Social Science & Medicine, Elsevier, vol. 306(C).
    4. Francesco Longo & Karl Claxton & James Lomas & Stephen Martin, 2020. "Does public long-term care expenditure improve care-related quality of life in England?," Working Papers 172cherp, Centre for Health Economics, University of York.
    5. Serrano-Alarcón, Manuel & Hernández-Pizarro, Helena & López-Casasnovas, Guillem & Nicodemo, Catia, 2022. "Effects of long-term care benefits on healthcare utilization in Catalonia," Journal of Health Economics, Elsevier, vol. 84(C).
    6. Manuel Serrano-Alarcón & Helena Hernández-Pizarro & Guillem López i Casasnovas & Catia Nicodemo, 2021. "The effect of Long-Term Care (LTC) benefits on healthcare use," Working Papers 2021-12, FEDEA.
    7. Francesco Longo & Karl Claxton & James Lomas & Stephen Martin, 2021. "Does public long‐term care expenditure improve care‐related quality of life of service users in England?," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2561-2581, September.
    8. Walsh, Brendan & Wren, Maev-Ann & Smith, Samantha & Lyons, Seán & Eighan, James & Morgenroth, Edgar, 2019. "An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital," Research Series, Economic and Social Research Institute (ESRI), number RS91, June.

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    More about this item

    Keywords

    Substitution; Social care; Primary care; Older people;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I19 - Health, Education, and Welfare - - Health - - - Other

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