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Local Variability in Long‐Term Care Services: Local Autonomy, Exogenous Influences and Policy Spillovers

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  • José‐Luis Fernandez
  • Julien Forder

Abstract

In many countries, public responsibility over the funding and provision of long‐term care services is held at the local level. In such systems, long‐term care provision is often characterised by significant local variability. Using a panel dataset of local authorities over the period 2002–2012, the paper investigates the underlying causes of variation in gross social care expenditure for older people in England. The analysis distinguishes between factors outside the direct control of policy makers, local preferences and local policy spillovers. The results indicate that local demand and supply factors, and to a much lesser extent local political preferences and spatial policy spillovers, explain a large majority of the observed variation in expenditure. Copyright © 2015 John Wiley & Sons, Ltd.

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  • José‐Luis Fernandez & Julien Forder, 2015. "Local Variability in Long‐Term Care Services: Local Autonomy, Exogenous Influences and Policy Spillovers," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 146-157, March.
  • Handle: RePEc:wly:hlthec:v:24:y:2015:i:s1:p:146-157
    DOI: 10.1002/hec.3151
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    2. Castro, Marcelo Araújo & Mattos, Enlinson & Patriota, Fernanda, 2016. "Spatial spillovers and political coordination in public health provision," Textos para discussão 417, FGV EESP - Escola de Economia de São Paulo, Fundação Getulio Vargas (Brazil).
    3. Jeremy McCauley, 2020. "The Role of Information in Explaining the Lack of Welfare-Induced Migration," Bristol Economics Discussion Papers 20/729, School of Economics, University of Bristol, UK.
    4. Maja Matanic Vautmans & Marijana Oreb & Sasa Drezgic, 2023. "Socioeconomic inequality in the use of long-term care for the elderly in Europe," Public Sector Economics, Institute of Public Finance, vol. 47(2), pages 149-176.
    5. Marenzi, Anna & Rizzi, Dino & Zanette, Michele & Zantomio, Francesca, 2023. "Regional institutional quality and territorial equity in LTC provision," The Journal of the Economics of Ageing, Elsevier, vol. 26(C).
    6. Waitzberg, Ruth & Schmidt, Andrea E. & Blümel, Miriam & Penneau, Anne & Farmakas, Antonis & Ljungvall, Åsa & Barbabella, Francesco & Augusto, Gonçalo Figueiredo & Marchildon, Gregory P. & Saunes, Ingr, 2020. "Mapping variability in allocation of Long-Term Care funds across payer agencies in OECD countries," Health Policy, Elsevier, vol. 124(5), pages 491-500.
    7. Stefania Ilinca & Ricardo Rodrigues & Andrea E. Schmidt, 2017. "Fairness and Eligibility to Long-Term Care: An Analysis of the Factors Driving Inequality and Inequity in the Use of Home Care for Older Europeans," IJERPH, MDPI, vol. 14(10), pages 1-15, October.
    8. Marenzi, A.; & Rizzi, D.; & Zanette, M.; & Zantomio, F.;, 2022. "Regional Institutional Quality and Territorial Equity in LTC Provision," Health, Econometrics and Data Group (HEDG) Working Papers 22/27, HEDG, c/o Department of Economics, University of York.
    9. Shun-ichiro Bessho & Yoko Ibuka, 2016. "Vaccination policy of Japanese municipalities," Keio-IES Discussion Paper Series 2016-004, Institute for Economics Studies, Keio University.
    10. Shun‐ichiro Bessho & Yoko Ibuka, 2019. "Interdependency in vaccination policies among Japanese municipalities," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 299-310, February.
    11. 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.

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    JEL classification:

    • J50 - Labor and Demographic Economics - - Labor-Management Relations, Trade Unions, and Collective Bargaining - - - General

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