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Eliciting the demand for long-term care coverage: a discrete choice modelling analysis

  • Rinaldo Brau

    (Department of Economics and CRENoS, University of Cagliari, Cagliari, Italy)

  • Matteo Lippi Bruni

    (Department of Economics, University of Bologna, Bologna, Italy)

We evaluate the demand for long-term care (LTC) insurance prospects in a stated preference context, by means of the results of a choice experiment carried out on a representative sample of the Emilia-Romagna population. In this paper, these methods are first of all used in order to assess the relative importance of the characteristics that define hypothetical insurance programmes and to elicit the willingness to pay for some LTC coverage prospects. Moreover, thanks to the application of a nested logit specification with 'partial degeneracy', we are able to model the determinants of the preference for status quo situations where no systematic cover for LTC exists. On the basis of this empirical model, we test for the effects of a series of socio-demographic variables as well as personal and household health-state indicators. Copyright © 2007 John Wiley & Sons, Ltd.

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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 17 (2008)
Issue (Month): 3 ()
Pages: 411-433

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Handle: RePEc:wly:hlthec:v:17:y:2008:i:3:p:411-433
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  1. Gary L. Hunt, 2000. "Alternative Nested Logit Model Structures and the Special Case of Partial Degeneracy," Journal of Regional Science, Wiley Blackwell, vol. 40(1), pages 89-113.
  2. J.M.C. Santos Silva, 2004. "Deriving welfare measures in discrete choice experiments: a comment to Lancsar and Savage (2)," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 913-918.
  3. Juan Antonio Carrasco & Juan de Dios Ort�zar, 2002. "Review and assessment of the nested logit model," Transport Reviews, Taylor & Francis Journals, vol. 22(2), pages 197-218, January.
  4. Tim Besley & John Hall & Ian Preston, 1996. "The demand for private health insurance: do waiting lists matter?," IFS Working Papers W96/07, Institute for Fiscal Studies.
  5. Brouwer, Roy & Bateman, Ian J., 2005. "Benefits transfer of willingness to pay estimates and functions for health-risk reductions: a cross-country study," Journal of Health Economics, Elsevier, vol. 24(3), pages 591-611, May.
  6. Carol Propper, 1995. "The Disutility of Time Spent on the United Kingdom's National Health Service Waiting Lists," Journal of Human Resources, University of Wisconsin Press, vol. 30(4), pages 677-700.
  7. Nick Hanley & Mandy Ryan & Robert Wright, 2003. "Estimating the monetary value of health care: lessons from environmental economics," Health Economics, John Wiley & Sons, Ltd., vol. 12(1), pages 3-16.
  8. Mandy Ryan, 2004. "Deriving welfare measures in discrete choice experiments: a comment to Lancsar and Savage (1)," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 909-912.
  9. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D., 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304, October.
  10. McFadden, Daniel L., 1984. "Econometric analysis of qualitative response models," Handbook of Econometrics, in: Z. Griliches† & M. D. Intriligator (ed.), Handbook of Econometrics, edition 1, volume 2, chapter 24, pages 1395-1457 Elsevier.
  11. Sloan, Frank A & Norton, Edward C, 1997. "Adverse Selection, Bequests, Crowding Out, and Private Demand for Insurance: Evidence from the Long-Term Care Insurance Market," Journal of Risk and Uncertainty, Springer, vol. 15(3), pages 201-19, December.
  12. Sloan, Frank A & Picone, Gabriel & Hoerger, Thomas J, 1997. "The Supply of Children's Time to Disabled Elderly Parents," Economic Inquiry, Western Economic Association International, vol. 35(2), pages 295-308, April.
  13. Brown, Jeffrey R. & Finkelstein, Amy, 2007. "Why is the market for long-term care insurance so small?," Journal of Public Economics, Elsevier, vol. 91(10), pages 1967-1991, November.
  14. Bateman, Ian J. & Cole, Matthew & Cooper, Philip & Georgiou, Stavros & Hadley, David & Poe, Gregory L., 2004. "On visible choice sets and scope sensitivity," Journal of Environmental Economics and Management, Elsevier, vol. 47(1), pages 71-93, January.
  15. Thomas Philipson & Darius Lakdawalla, 1998. "The Rise in Old Age Longevity and the Market for Long-Term Care," University of Chicago - George G. Stigler Center for Study of Economy and State 146, Chicago - Center for Study of Economy and State.
  16. Norton, Edward C., 2000. "Long-term care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 17, pages 955-994 Elsevier.
  17. Ruth Hancock & Adelina Comas-Herrera & Raphael Wittenberg & Linda Pickard, 2003. "Who Will Pay for Long-Term Care in the UK? Projections Linking Macro- and Micro-Simulation Models," Fiscal Studies, Institute for Fiscal Studies, vol. 24(4), pages 387-426, December.
  18. Hensher, David A. & Greene, William H., 2002. "Specification and estimation of the nested logit model: alternative normalisations," Transportation Research Part B: Methodological, Elsevier, vol. 36(1), pages 1-17, January.
  19. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521747387, October.
  20. Karolin Becker & Peter Zweifel, 2004. "Age and Choice in Health Insurance: Evidence from Switzerland," SOI - Working Papers 0410, Socioeconomic Institute - University of Zurich, revised Jun 2007.
  21. Harry Telser & Peter Zweifel, 2003. "Validity of Discrete-Choice Experiments - Evidence for Health Risk Reduction," SOI - Working Papers 0313, Socioeconomic Institute - University of Zurich, revised Feb 2005.
  22. R. Brau & M. Lippi Bruni & AM. Pinna, 2004. "Public vs private demand for covering long term care expenditures," Working Paper CRENoS 200408, Centre for North South Economic Research, University of Cagliari and Sassari, Sardinia.
  23. Propper, Carol, 1993. "Constrained choice sets in the U.K. demand for private medical insurance," Journal of Public Economics, Elsevier, vol. 51(3), pages 287-307, July.
  24. Meier, Volker, 1999. "Why the young do not buy long-term care insurance," Munich Reprints in Economics 19205, University of Munich, Department of Economics.
  25. Emily Lancsar & Elizabeth Savage, 2004. "Deriving welfare measures from discrete choice experiments: inconsistency between current methods and random utility and welfare theory," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 901-907.
  26. Hanley, Nick & Mourato, Susana & Wright, Robert E, 2001. " Choice Modelling Approaches: A Superior Alternative for Environmental Valuation?," Journal of Economic Surveys, Wiley Blackwell, vol. 15(3), pages 435-62, July.
  27. Joan Costa Font & Juan Rovira Forns, 2004. "Willigness to Pay for Long-Term Care Coverage: the Role of Private Information and Self-Insurance," Working Papers in Economics 124, Universitat de Barcelona. Espai de Recerca en Economia.
  28. Pauly, Mark V, 1990. "The Rational Nonpurchase of Long-term-Care Insurance," Journal of Political Economy, University of Chicago Press, vol. 98(1), pages 153-68, February.
  29. David M. Cutler, 1993. "Why Doesn't the Market Fully Insure Long-Term Care?," NBER Working Papers 4301, National Bureau of Economic Research, Inc.
  30. Mandy Ryan & Diane Skåtun, 2004. "Modelling non-demanders in choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 397-402.
  31. Mellor, Jennifer M., 2001. "Long-term care and nursing home coverage: are adult children substitutes for insurance policies?," Journal of Health Economics, Elsevier, vol. 20(4), pages 527-547, July.
  32. Karlsson, Martin & Mayhew, Les & Rickayzen, Ben, 2007. "Long term care financing in four OECD countries: Fiscal burden and distributive effects," Health Policy, Elsevier, vol. 80(1), pages 107-134, January.
  33. Propper, Carol, 1990. "Contingent Valuation of Time Spent on NHS Waiting Lists," Economic Journal, Royal Economic Society, vol. 100(400), pages 193-99, Supplemen.
  34. Jeffrey R. Brown & Amy Finkelstein, 2004. "Supply or Demand: Why is the Market for Long-Term Care Insurance So Small?," NBER Working Papers 10782, National Bureau of Economic Research, Inc.
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