IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v30y2021i10p2561-2581.html
   My bibliography  Save this article

Does public long‐term care expenditure improve care‐related quality of life of service users in England?

Author

Listed:
  • Francesco Longo
  • Karl Claxton
  • James Lomas
  • Stephen Martin

Abstract

Public long‐term care (LTC) systems provide services to support people experiencing difficulties with their activities of daily living. This study investigates the marginal effect of changes in public LTC expenditure on care‐related quality of life (CRQoL) of existing service users in England. The public LTC program for people aged 18 or older in England is called Adult Social Care (ASC) and it is provided and managed by local authorities. We collect data on the outcomes and characteristics of public ASC users, on public ASC expenditure, and on the characteristics of local authorities across England in 2017/18. We employ an instrumental variable approach using conditionally exogenous elements of the public funding system to estimate the effect of public ASC expenditure on user CRQoL. Our findings show that by increasing public ASC expenditure by £1000 per user, on average, local authorities increase user CRQoL by 0.0030. These results suggest that public ASC is effective in increasing users' quality of life but only to a relatively small extent. When combined with the other potential effects of LTC expenditure (e.g., on informal carers, mortality), this study can inform policy makers in the United Kingdom and internationally about whether social care provides good value for money.

Suggested Citation

  • 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.
  • Handle: RePEc:wly:hlthec:v:30:y:2021:i:10:p:2561-2581
    DOI: 10.1002/hec.4396
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.4396
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.4396?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Karl Claxton & James Lomas & Stephen Martin, 2018. "The impact of NHS expenditure on health outcomes in England: Alternative approaches to identification in all‐cause and disease specific models of mortality," Health Economics, John Wiley & Sons, Ltd., vol. 27(6), pages 1017-1023, June.
    2. Gary S. Becker, 1981. "A Treatise on the Family," NBER Books, National Bureau of Economic Research, Inc, number beck81-1, March.
    3. Martyn Andrews & Obbey Elamin & Alastair R. Hall & Kostas Kyriakoulis & Matthew Sutton, 2017. "Inference in the presence of redundant moment conditions and the impact of government health expenditure on health outcomes in England," Econometric Reviews, Taylor & Francis Journals, vol. 36(1-3), pages 23-41, March.
    4. Martin, Stephen & Rice, Nigel & Smith, Peter C., 2008. "Does health care spending improve health outcomes? Evidence from English programme budgeting data," Journal of Health Economics, Elsevier, vol. 27(4), pages 826-842, July.
    5. Adrian Adermon & Mikael Lindahl & Daniel Waldenström, 2018. "Intergenerational Wealth Mobility and the Role of Inheritance: Evidence from Multiple Generations," Economic Journal, Royal Economic Society, vol. 128(612), pages 482-513, July.
    6. Gigliotti, Philip & Sorensen, Lucy C., 2018. "Educational resources and student achievement: Evidence from the Save Harmless provision in New York State," Economics of Education Review, Elsevier, vol. 66(C), pages 167-182.
    7. Joshua Hyman, 2017. "Does Money Matter in the Long Run? Effects of School Spending on Educational Attainment," American Economic Journal: Economic Policy, American Economic Association, vol. 9(4), pages 256-280, November.
    8. van Leeuwen, K.M. & Malley, J. & Bosmans, J.E. & Jansen, A.P.D. & Ostelo, R.W. & van der Horst, H.E. & Netten, A., 2014. "What can local authorities do to improve the social care-related quality of life of older adults living at home?: evidence from the adult social care survey," LSE Research Online Documents on Economics 58022, London School of Economics and Political Science, LSE Library.
    9. Jonathan Siverskog & Martin Henriksson, 2019. "Estimating the marginal cost of a life year in Sweden’s public healthcare sector," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 751-762, July.
    10. ., 2018. "Financing local and regional government," Chapters, in: Fiscal Decentralization and Local Finance in Developing Countries, chapter 5, pages 167-226, Edward Elgar Publishing.
    11. Julien Forder & Juliette Malley & Ann‐Marie Towers & Ann Netten, 2014. "Using Cost‐Effectiveness Estimates From Survey Data To Guide Commissioning: An Application To Home Care," Health Economics, John Wiley & Sons, Ltd., vol. 23(8), pages 979-992, August.
    12. Hægeland, Torbjørn & Raaum, Oddbjørn & Salvanes, Kjell G., 2012. "Pennies from heaven? Using exogenous tax variation to identify effects of school resources on pupil achievement," Economics of Education Review, Elsevier, vol. 31(5), pages 601-614.
    13. Rhee, Jong Chul & Done, Nicolae & Anderson, Gerard F., 2015. "Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany," Health Policy, Elsevier, vol. 119(10), pages 1319-1329.
    14. Jacobs,Rowena & Smith,Peter C. & Street,Andrew, 2006. "Measuring Efficiency in Health Care," Cambridge Books, Cambridge University Press, number 9780521851442.
    15. Compton, Janice & Pollak, Robert A., 2014. "Family proximity, childcare, and women’s labor force attachment," Journal of Urban Economics, Elsevier, vol. 79(C), pages 72-90.
    16. Linda Datcher Loury, 2006. "All in the Extended Family: Effects of Grandparents, Aunts, and Uncles on Educational Attainment," American Economic Review, American Economic Association, vol. 96(2), pages 275-278, May.
    17. James Gaughan & Hugh Gravelle & Luigi Siciliani, 2014. "Testing the bed-blocking hypothesis: does higher supply of nursing and care homes reduce delayed hospital discharges?," Working Papers 102cherp, Centre for Health Economics, University of York.
    18. 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.
    19. Sean Urwin & Yiu‐Shing Lau & Thomas Mason, 2019. "Investigating the relationship between formal and informal care: An application using panel data for people living together," Health Economics, John Wiley & Sons, Ltd., vol. 28(8), pages 984-997, August.
    20. Goodspeed, Timothy J., 2000. "Tax structure in a federation," Journal of Public Economics, Elsevier, vol. 75(3), pages 493-506, March.
    21. Linda Loury, 2006. "All in the Extended Family: Grandparents, Aunts, and Uncles and Educational Attainment," Discussion Papers Series, Department of Economics, Tufts University 0618, Department of Economics, Tufts University.
    22. Sonia Bhalotra, 2007. "Spending to save? State health expenditure and infant mortality in India," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 911-928, September.
    23. Jose-Luis Fernandez & J. Forder, 2008. "Consequences of local variations in social care on the performance of the acute health care sector," Applied Economics, Taylor & Francis Journals, vol. 40(12), pages 1503-1518.
    24. Julien Forder, 2009. "Long‐term care and hospital utilisation by older people: an analysis of substitution rates," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1322-1338, November.
    25. Amy Finkelstein & Kathleen McGarry, 2006. "Multiple Dimensions of Private Information: Evidence from the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 96(4), pages 938-958, September.
    26. Linda Loury, 2006. "All in the Extended Family: Grandparents, Aunts, and Uncles and Educational Attainment," Discussion Papers Series, Department of Economics, Tufts University 0610, Department of Economics, Tufts University.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    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. 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.
    4. Kieron J. Barclay & Dalton Conley, 2022. "The influence of cousin order and cousin group size on educational outcomes," MPIDR Working Papers WP-2022-013, Max Planck Institute for Demographic Research, Rostock, Germany.
    5. Angelucci, Manuela & De Giorgi, Giacomo & Rangel, Marcos A. & Rasul, Imran, 2010. "Family networks and school enrolment: Evidence from a randomized social experiment," Journal of Public Economics, Elsevier, vol. 94(3-4), pages 197-221, April.
    6. Arnstein Aassve & Elena Meroni & Chiara Pronzato, 2012. "Grandparenting and Childbearing in the Extended Family," European Journal of Population, Springer;European Association for Population Studies, vol. 28(4), pages 499-518, November.
    7. 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.
    8. Samuel Owusu & Samuel Tawiah Baidoo, 2021. "Providing a safety net for the vulnerable persons in Ghana: Does the extended family matter?," International Journal of Social Welfare, John Wiley & Sons, vol. 30(2), pages 208-215, April.
    9. Rowena Crawford & George Stoye & Ben Zaranko, 2018. "The impact of cuts to social care spending on the use of Accident and Emergency departments in England," IFS Working Papers W18/15, Institute for Fiscal Studies.
    10. Emanuele Arcà & Francesco Principe & Eddy Van Doorslaer, 2020. "Death by austerity? The impact of cost containment on avoidable mortality in Italy," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1500-1516, December.
    11. Karin Monstad & Carol Propper & Kjell G. Salvanes, 2011. "Is teenage motherhood contagious? Evidence from a Natural Experiment," The Centre for Market and Public Organisation 11/262, The Centre for Market and Public Organisation, University of Bristol, UK.
    12. Orazio P. Attanasio & Valérie Lechene, 2014. "Efficient Responses to Targeted Cash Transfers," Journal of Political Economy, University of Chicago Press, vol. 122(1), pages 178-222.
    13. James Gaughan & Hugh Gravelle & Rita Santos & Luigi Siciliani, 2017. "Long-term care provision, hospital bed blocking, and discharge destination for hip fracture and stroke patients," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 311-331, September.
    14. Dan Liu & Maria Lucia Pace & Maria Goddard & Rowena Jacobs & Raphael Wittenberg & Anne Mason, 2021. "Investigating the relationship between social care supply and healthcare utilization by older people in England," Health Economics, John Wiley & Sons, Ltd., vol. 30(1), pages 36-54, January.
    15. Maria Gutiérrez-Domènech & Alícia Adserà, 2012. "Student Performance In Elementary Schools," Revista de Economia Aplicada, Universidad de Zaragoza, Departamento de Estructura Economica y Economia Publica, vol. 20(2), pages 135-164, Autumn.
    16. Mikael Lindahl & Mårten Palme & Sofia Sandgren Massih & Anna Sjögren, 2015. "Long-Term Intergenerational Persistence of Human Capital: An Empirical Analysis of Four Generations," Journal of Human Resources, University of Wisconsin Press, vol. 50(1), pages 1-33.
    17. 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.
    18. Jonathan Siverskog & Martin Henriksson, 2019. "Estimating the marginal cost of a life year in Sweden’s public healthcare sector," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 751-762, July.
    19. Brunner, Eric & Hoen, Ben & Hyman, Joshua, 2022. "School district revenue shocks, resource allocations, and student achievement: Evidence from the universe of U.S. wind energy installations," Journal of Public Economics, Elsevier, vol. 206(C).
    20. DeVolder, Russell & Serra-Sastre, Victoria & Zamora, Bernarda, 2020. "Examining the variation across acute trusts in patient delayed discharge," Health Policy, Elsevier, vol. 124(11), pages 1226-1232.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:30:y:2021:i:10:p:2561-2581. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.