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Eliciting the Demand for Long Term Care Coverage: A Discrete Choice Modelling Analysis

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  • Rinaldo Brau

    (University of Cagliari)

  • Matteo Lippi Bruni

    (University of Bologna)

Abstract

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. Choice modelling techniques have not been used yet for studying the demand for LTC services. In this paper these methods are first of all used in order to assess the relative importance of the characteristics which define some 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.

Suggested Citation

  • Rinaldo Brau & Matteo Lippi Bruni, 2006. "Eliciting the Demand for Long Term Care Coverage: A Discrete Choice Modelling Analysis," Working Papers 2006.71, Fondazione Eni Enrico Mattei.
    • Handle: RePEc:fem:femwpa:2006.71
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    1. 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.
    2. 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.
    3. 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.
    4. Darius Lakdawalla & Tomas Philipson, 2002. "The Rise in Old-Age Longevity and the Market for Long-Term Care," American Economic Review, American Economic Association, vol. 92(1), pages 295-306, March.
    5. Mandy Ryan & Diane Skåtun, 2004. "Modelling non‐demanders in choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 397-402, April.
    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, January.
    8. 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 201-219, December.
    9. Rinaldo Brau & Matteo Lippi Bruni & Anna Maria Pinna, 2010. "Public versus private demand for covering long-term care expenditures," Applied Economics, Taylor & Francis Journals, vol. 42(28), pages 3651-3668.
    10. 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, September.
    11. repec:bla:jecsur:v:15:y:2001:i:3:p:435-62 is not listed on IDEAS
    12. 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, September.
    13. Meier, Volker, 1999. "Why the Young Do Not Buy Long-Term Care Insurance," Journal of Risk and Uncertainty, Springer, vol. 18(1), pages 83-98, April.
    14. 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.
    15. 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.
    16. 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.
    17. 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.
    18. Louviere,Jordan J. & Hensher,David A. & Swait,Joffre D. With contributions by-Name:Adamowicz,Wiktor, 2000. "Stated Choice Methods," Cambridge Books, Cambridge University Press, number 9780521788304, Enero-Abr.
    19. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    20. 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.
    21. Darius Lakdawalla & Tomas Philipson, 2002. "The Rise in Old-Age Longevity and the Market for Long-Term Care," American Economic Review, American Economic Association, vol. 92(1), pages 295-306, March.
    22. Karlsson, Martin & Mayhew, Les & Rickayzen, Ben, 2007. "Long term care financing in 4 OECD countries: fiscal burden and distributive effects," Publications of Darmstadt Technical University, Institute for Business Studies (BWL) 34405, Darmstadt Technical University, Department of Business Administration, Economics and Law, Institute for Business Studies (BWL).
    23. Propper, Carol, 1990. "Contingent Valuation of Time Spent on NHS Waiting Lists," Economic Journal, Royal Economic Society, vol. 100(400), pages 193-199, Supplemen.
    24. Pauly, Mark V, 1990. "The Rational Nonpurchase of Long-term-Care Insurance," Journal of Political Economy, University of Chicago Press, vol. 98(1), pages 153-168, February.
    25. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521747387, Enero-Abr.
    26. Joseph A. Herriges & Catherine L. Kling (ed.), 1999. "Valuing Recreation and the Environment," Books, Edward Elgar Publishing, number 1315.
    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. David M. Cutler, 1993. "Why Doesn't the Market Fully Insure Long-Term Care?," NBER Working Papers 4301, National Bureau of Economic Research, Inc.
    29. 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.
    30. 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.
    31. Timothy C. Haab & Kenneth E. McConnell, 2002. "Valuing Environmental and Natural Resources," Books, Edward Elgar Publishing, number 2427.
    32. Juan Antonio Carrasco & Juan de Dios Ortúzar, 2002. "Review and assessment of the nested logit model," Transport Reviews, Taylor & Francis Journals, vol. 22(2), pages 197-218, January.
    33. 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.
    34. 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.
    35. 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.
    36. 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.
    37. 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, February.
    38. 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, September.
    39. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    40. M. Lippi Bruni & A.M. Pinna & Rinaldo Brau, 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.
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    3. Joachim Marti, 2012. "Assessing preferences for improved smoking cessation medications: a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 533-548, October.
    4. Domino Determann & Dorte Gyrd-Hansen & G. Ardine de Wit & Esther W. de Bekker-Grob & Ewout W. Steyerberg & Mattijs S. Lambooij & Line Bjørnskov Pedersen, 2019. "Designing Unforced Choice Experiments to Inform Health Care Decision Making: Implications of Using Opt-Out, Neither, or Status Quo Alternatives in Discrete Choice Experiments," Medical Decision Making, , vol. 39(6), pages 681-692, August.
    5. Lambregts, Timo R. & Schut, Frederik T., 2020. "Displaced, disliked and misunderstood: A systematic review of the reasons for low uptake of long-term care insurance and life annuities," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    6. Martin Eling & Omid Ghavibazoo, 2019. "Research on long-term care insurance: status quo and directions for future research," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 44(2), pages 303-356, April.
    7. Denis Charles & Magali Dumontet & Meglena Jeleva & Johanna Etner, 2024. "Behavioral drivers of individuals’ Term Life Insurance Demand: evidence from a Discrete Choice Experiment," EconomiX Working Papers 2024-23, University of Paris Nanterre, EconomiX.
    8. Akaichi, Faical & Costa-Font, Joan & Frank, Richard, 2020. "Uninsured by Choice? A choice experiment on long term care insurance," Journal of Economic Behavior & Organization, Elsevier, vol. 173(C), pages 422-434.
    9. Alessandro Mengoni & Chiara Seghieri & Sabina Nuti, 2013. "The application of discrete choice experiments in health economics: a systematic review of the literature," Working Papers 201301, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    10. Andriy Danyliv & Milena Pavlova & Irena Gryga & Wim Groot, 2015. "Preferences for physician services in Ukraine: a discrete choice experiment," International Journal of Health Planning and Management, Wiley Blackwell, vol. 30(4), pages 346-365, October.
    11. Kick, Markus & Littich, Martina, 2015. "Brand and Reputation as Quality Signals on Regulated Markets," EconStor Preprints 182503, ZBW - Leibniz Information Centre for Economics.
    12. Song, Shan & Wang, De & Zhu, Wei & Wang, Can, 2020. "Study on the spatial configuration of nursing homes for the elderly people in Shanghai: Based on their choice preference," Technological Forecasting and Social Change, Elsevier, vol. 152(C).
    13. T. Lehnert & O. H. Günther & A. Hajek & S. G. Riedel-Heller & H. H. König, 2018. "Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(9), pages 1213-1223, December.
    14. Kick, Markus, 2015. "The Price Premium Induced by Branding: A Health Care Case Study," EconStor Preprints 182504, ZBW - Leibniz Information Centre for Economics.
    15. 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.
    16. Wang, Qun & Abiiro, Gilbert Abotisem & Yang, Jin & Li, Peng & De Allegri, Manuela, 2021. "Preferences for long-term care insurance in China: Results from a discrete choice experiment," Social Science & Medicine, Elsevier, vol. 281(C).
    17. Philip Worrall & Thierry Chaussalet, 2015. "A structured review of long-term care demand modelling," Health Care Management Science, Springer, vol. 18(2), pages 173-194, June.

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    More about this item

    Keywords

    Health Insurance; Long Term Care; Choice Experiments; Nested Logit Models;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H40 - Public Economics - - Publicly Provided Goods - - - General
    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities

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