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A Country For Old Men? Long‐Term Home Care Utilization In Europe

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  • Silvia Balia
  • Rinaldo Brau

Abstract

This paper investigates long‐term home care utilization in Europe. Data from the first wave of the Survey on Health, Ageing and Retirement (SHARE) on formal (nursing care and paid domestic help) and informal care (support provided by relatives) are used to study the probability and the quantity of both types of care. The overall process is framed in a fully simultaneous equation system that takes the form of a bivariate two‐part model where the reciprocal interaction between formal and informal care is estimated. Endogeneity and unobservable heterogeneity are addressed using a common latent factor approach. The analysis of the relative impact of age and disability on home care utilization is enriched by the use of a proximity to death (PtD) indicator built using the second wave of SHARE. All these indicators are important predictors of home care utilization. In particular, a strong significant effect of PtD is found in the paid domestic help and informal care models. The relationship between formal and informal care moves from substitutability to complementarity depending on the type of care considered, and the estimated effects are small in absolute size. This might call for a reconsideration of the effectiveness of incentives for informal care as instruments to reduce public expenditure for home care services. Copyright © 2013 John Wiley & Sons, Ltd.

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  • Silvia Balia & Rinaldo Brau, 2014. "A Country For Old Men? Long‐Term Home Care Utilization In Europe," Health Economics, John Wiley & Sons, Ltd., vol. 23(10), pages 1185-1212, October.
    • Handle: RePEc:wly:hlthec:v:23:y:2014:i:10:p:1185-1212
    DOI: 10.1002/hec.2977
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    2. Carrino, L.; & Nafilyan, V.; & Avendaño Pabon, M.;, 2019. "Should I Care or Should I Work? The Impact of Working in Older Age on Caregiving," Health, Econometrics and Data Group (HEDG) Working Papers 19/23, HEDG, c/o Department of Economics, University of York.
    3. Breyer, Friedrich & Lorenz, Normann & Ihle, Peter, 2020. "Aging and Health Care Expenditure: A non-parametric approach," VfS Annual Conference 2020 (Virtual Conference): Gender Economics 224635, Verein für Socialpolitik / German Economic Association.
    4. Ludovico Carrino & Cristina Elisa Orso, 2014. "Eligibility and inclusiveness of Long-Term Care Institutional frameworks in Europe: a cross-country comparison," Working Papers 2014:28, Department of Economics, University of Venice "Ca' Foscari".
    5. Norman Bannenberg & Oddvar Førland & Tor Iversen & Martin Karlsson & Henning Øien, 2021. "Preventive Home Visits," American Journal of Health Economics, University of Chicago Press, vol. 7(4), pages 457-496.
    6. Shinya Sugawara & Tsunehiro Ishihara & Susumu Kunisawa & Etsu Goto & Yuichi Imanaka, 2024. "A panel vector autoregression analysis for the dynamics of medical and long‐term care expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 748-763, April.
    7. Matthias Firgo & Klaus Nowotny & Alexander Braun, 2020. "Informal, formal, or both? Assessing the drivers of home care utilization in Austria using a simultaneous decision framework," Applied Economics, Taylor & Francis Journals, vol. 52(40), pages 4440-4456, August.
    8. Wilfried Guets, 2021. "Does the formal home care provided to old-adults persons affect utilisation of support services by informal carers? An analysis of the French CARE and the U.S. NHATS/NSOC surveys," Working Papers halshs-03115306, HAL.
    9. Elenka Brenna & Cinzia Di Novi, 2013. "Is caring for elderly parents detrimental to women’s mental health? The influence of the European North-South gradient," DISCE - Working Papers del Dipartimento di Economia e Finanza def004, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    10. Vincenzo Atella & Federico Belotti & Ludovico Carrino & Andrea Piano Mortari, 2017. "The future of Long Term Care in Europe. An investigation using a dynamic microsimulation model," CEIS Research Paper 405, Tor Vergata University, CEIS, revised 08 May 2017.
    11. Matthias Firgo & Klaus Nowotny & Alexander Braun, 2017. "Austria 2025 – Informal, Formal, or Both? Assessing the Drivers of Home Care Utilisation in Austria Using a Simultaneous Decision Framework," WIFO Studies, WIFO, number 59741, February.
    12. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    13. van Noort, Olivier & Schotanus, Fredo & van de Klundert, Joris & Telgen, Jan, 2018. "Explaining regional variation in home care use by demand and supply variables," Health Policy, Elsevier, vol. 122(2), pages 140-146.
    14. Aurea Grané & Irene Albarrán & Qi Guo, 2021. "Visualizing Health and Well-Being Inequalities Among Older Europeans," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 155(2), pages 479-503, June.
    15. Ludovico Carrino & Cristina Elisa Orso & Giacomo Pasini, 2018. "Demand of long‐term care and benefit eligibility across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 27(8), pages 1175-1188, August.
    16. Wilfried Guets, 2021. "Does the formal home care provided to old-adults persons affect utilisation of support services by informal carers? An analysis of the French CARE and the U.S. NHATS/NSOC surveys," Working Papers 2105, Groupe d'Analyse et de Théorie Economique Lyon St-Étienne (GATE Lyon St-Étienne), Université de Lyon.
    17. Cinzia Di Novi & Elenka Brenna, 2013. "Is caring for elderly parents detrimental for women�s mental health? The influence of the European North-South gradient," Working Papers 2013:23, Department of Economics, University of Venice "Ca' Foscari".
    18. Ulrike Famira-Mühlberger & Matthias Firgo, 2018. "Aktuelle und künftige Versorgungsfunktion der mobilen Pflege- und Betreuungsdienste in Österreich," WIFO Studies, WIFO, number 61563.
    19. Shinya Sugawara, 2022. "What composes desirable formal at-home elder care? An analysis for multiple service combinations," The Japanese Economic Review, Springer, vol. 73(2), pages 373-402, April.
    20. Sevilla, J.P. & Stawasz, Andrew & Burnes, Daria & Poulsen, Peter Bo & Sato, Reiko & Bloom, David E., 2019. "Indirect costs of adult pneumococcal disease and productivity-based rate of return to PCV13 vaccination for older adults and elderly diabetics in Denmark," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).
    21. Bergeot, Julien & Tenand, Marianne, 2023. "Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data," Journal of Health Economics, Elsevier, vol. 92(C).

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