Geographical and financial access to nursing homes: theoretical presentation of a measurement indicator[Accès géographique et financier aux Ehpad : présentation théorique d’un indicateur de mesure]

Measuring the accessibility of care in nursing homes (Ehpads) is a key-element in the monitoring and evaluation of public policies for disabled elderly people. The relevance of such a measure is reinforced by the current context in many OECD countries, where the aging of the population is combined with the wish of public authorities to limit the creation of Ehpads new places. This note proposes a new family of measurement indicators, specifically designed to assess the consequences of French public policies, particularly in terms of territorial equity : to take into account of the potentially high out-of-pocket expenses and of the fact that regulation is largely decentralized at the departmental councils, these indicators aim to quantify the geographical and financial accessibility of Ehpad (AGFE), for a given individual, according to income level and location. The main indicator defined here can be adapted by modifying the target groups, or by integrating rules for prioritizing potential demand.