IDEAS home Printed from https://ideas.repec.org/p/hal/journl/hal-05460270.html

Home vs. nursing care: Unpacking the impact on health and well-being

Author

Listed:
  • Elena Bassoli

    (ETH Zürich - Eidgenössische Technische Hochschule - Swiss Federal Institute of Technology [Zürich])

  • Mathieu Lefebvre

    (BETA - Bureau d'Économie Théorique et Appliquée - AgroParisTech - UNISTRA - Université de Strasbourg - Université de Haute-Alsace (UHA) - Université de Haute-Alsace (UHA) Mulhouse - Colmar - UL - Université de Lorraine - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

  • Jérôme Schoenmaeckers

    (ULiège - Université de Liège = University of Liège = Universiteit van Luik = Universität Lüttich)

Abstract

In this paper, we present estimates of the effect of different care settings on health and well-being outcomes. We use data from the French CARE Survey, which interviews individuals aged 60 and above, to assess the differential effect of living at home or in a nursing home on mortality, morbidity and well-being indicators. In addition, we differentiate the effect between for-profit and non-profit nursing homes. To do so, we apply a propensity score matching approach that controls for selection on observables by matching people living at home with those living in nursing homes. Our results are threefold. First, we observe a positive effect of being in a nursing home on health outcomes but a negative effect on other well-being indicators such as happiness and nervousness. Second, the ownership status of the nursing home matters and the positive effect is stronger for non-profit and public nursing homes. Third, residents in for-profit nursing homes appear to to be worse off than those in nonprofit institutions. These findings raise important questions for the future organization and the funding of long-term care.

Suggested Citation

  • Elena Bassoli & Mathieu Lefebvre & Jérôme Schoenmaeckers, 2025. "Home vs. nursing care: Unpacking the impact on health and well-being," Post-Print hal-05460270, HAL.
    • Handle: RePEc:hal:journl:hal-05460270
    DOI: 10.1016/j.socscimed.2025.118533
    Note: View the original document on HAL open archive server: https://univoak.hal.science/hal-05460270v1
    as

    Download full text from publisher

    File URL: https://univoak.hal.science/hal-05460270v1/document
    Download Restriction: no
    File URL: https://libkey.io/10.1016/j.socscimed.2025.118533?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
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Judith Bom & Pieter Bakx & Sara Rellstab, 2022. "Well‐being right before and after a permanent nursing home admission," Health Economics, John Wiley & Sons, Ltd., vol. 31(12), pages 2558-2574, December.
    2. Andrea Ichino & Fabrizia Mealli & Tommaso Nannicini, 2008. "From temporary help jobs to permanent employment: what can we learn from matching estimators and their sensitivity?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 23(3), pages 305-327.
    3. Xavier Flawinne & Mathieu Lefebvre & Sergio Perelman & Pierre Pestieau & Jérôme Schoenmaeckers, 2023. "Nursing homes and mortality in Europe: Uncertain causality," Health Economics, John Wiley & Sons, Ltd., vol. 32(1), pages 134-154, January.
    4. Rapp, Thomas & Apouey, Bénédicte H. & Senik, Claudia, 2018. "The impact of institution use on the wellbeing of Alzheimer's disease patients and their caregivers," Social Science & Medicine, Elsevier, vol. 207(C), pages 1-10.
    5. Amélie Carrère & Emmanuelle Cambois & Roméo Fontaine, 2023. "Institutional Long-Term Care Use in France (2008-2015): The Role of Family Resources," Post-Print halshs-03956426, HAL.
    6. K. Bolin & B. Lindgren & P. Lundborg, 2008. "Informal and formal care among single‐living elderly in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 393-409, March.
    7. Lucy Kok & Caroline Berden & Klarita Sadiraj, 2015. "Costs and benefits of home care for the elderly versus residential care: a comparison using propensity scores," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(2), pages 119-131, March.
    8. Stolt, Ragnar & Blomqvist, Paula & Winblad, Ulrika, 2011. "Privatization of social services: Quality differences in Swedish elderly care," Social Science & Medicine, Elsevier, vol. 72(4), pages 560-567, February.
    9. Van Houtven, Courtney Harold & Norton, Edward C., 2004. "Informal care and health care use of older adults," Journal of Health Economics, Elsevier, vol. 23(6), pages 1159-1180, November.
    10. Grabowski, David C. & Hirth, Richard A., 2003. "Competitive spillovers across non-profit and for-profit nursing homes," Journal of Health Economics, Elsevier, vol. 22(1), pages 1-22, January.
    11. Kim, Hyuncheol Bryant & Lim, Wilfredo, 2015. "Long-term care insurance, informal care, and medical expenditures," Journal of Public Economics, Elsevier, vol. 125(C), pages 128-142.
    12. Amélie Carrère & Emmanuelle Cambois & Roméo Fontaine, 2023. "Institutional Long-Term Care Use in France (2008-2015): The Role of Family Resources," Institut des Politiques Publiques halshs-03956426, HAL.
    13. Yaa Akosa Antwi & John R. Bowblis, 2018. "The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession," American Journal of Health Economics, University of Chicago Press, vol. 4(2), pages 131-163, Spring.
    14. Hjelmar, Ulf & Bhatti, Yosef & Petersen, Ole Helby & Rostgaard, Tine & Vrangbæk, Karsten, 2018. "Public/private ownership and quality of care: Evidence from Danish nursing homes," Social Science & Medicine, Elsevier, vol. 216(C), pages 41-49.
    15. Guido W. Imbens, 2015. "Matching Methods in Practice: Three Examples," Journal of Human Resources, University of Wisconsin Press, vol. 50(2), pages 373-419.
    16. Haizhen Lin, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Working Papers 2014-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    17. Lin, Haizhen, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 37(C), pages 13-24.
    18. Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    19. Bonsang, Eric, 2009. "Does informal care from children to their elderly parents substitute for formal care in Europe?," Journal of Health Economics, Elsevier, vol. 28(1), pages 143-154, January.
    20. Justina Klimaviciute & Sergio Perelman & Pierre Pestieau & Jerome Schoenmaeckers, 2017. "Caring for dependent parents: Altruism, exchange or family norm?," Journal of Population Economics, Springer;European Society for Population Economics, vol. 30(3), pages 835-873, July.
    21. Cristina Giudici & Silvia Polettini & Alessandra Rose & Nicolas Brouard, 2019. "Which Aspects of Elderly Living Conditions are Important to Predict Mortality? The Complex Role of Family Ties at Home and in Institutions," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 142(3), pages 1255-1283, April.
    22. Andrea Wysocki & Mary Butler & Robert L. Kane & Rosalie A. Kane & Tetyana Shippee & François Sainfort, 2015. "Long-Term Services and Supports for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care," Mathematica Policy Research Reports 30503869a2a744d387ea9ac13, Mathematica Policy Research.
    23. Amélie Carrère & Emmanuelle Cambois & Roméo Fontaine, 2023. "Institutional Long-Term Care Use in France (2008-2015): The Role of Family Resources," Economie et Statistique / Economics and Statistics, Institut National de la Statistique et des Etudes Economiques (INSEE), issue 538, pages 31-48.
    24. Grabowski, David C. & Feng, Zhanlian & Hirth, Richard & Rahman, Momotazur & Mor, Vincent, 2013. "Effect of nursing home ownership on the quality of post-acute care: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 32(1), pages 12-21.
    25. Amélie Carrère & Emmanuelle Cambois & Roméo Fontaine, 2023. "Institutional Long-Term Care Use in France (2008-2015): The Role of Family Resources," PSE-Ecole d'économie de Paris (Postprint) halshs-03956426, HAL.
    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. Xavier Flawinne & Mathieu Lefebvre & Sergio Perelman & Pierre Pestieau & Jérôme Schoenmaeckers, 2023. "Nursing homes and mortality in Europe: Uncertain causality," Health Economics, John Wiley & Sons, Ltd., vol. 32(1), pages 134-154, January.
    2. 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.
    3. 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).
    4. Hollingsworth, Bruce & Ohinata, Asako & Picchio, Matteo & Walker, Ian, 2022. "Does It Matter Who Cares for You? The Effect of Substituting Informal with Formal Personal Care on the Care Recipients' Health," IZA Discussion Papers 15457, IZA Network @ LISER.
    5. Herr, A. & Saric, A., 2016. "The Welfare Effects of Single Rooms in German Nursing Homes: A Structural Approach," Health, Econometrics and Data Group (HEDG) Working Papers 16/23, HEDG, c/o Department of Economics, University of York.
    6. Christophe Courbage & Guillem Montoliu-Montes & Joël Wagner, 2020. "The effect of long-term care public benefits and insurance on informal care from outside the household: empirical evidence from Italy and Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1131-1147, November.
    7. Mommaerts, Corina & Truskinovsky, Yulya, 2020. "The cyclicality of informal care," Journal of Health Economics, Elsevier, vol. 71(C).
    8. Judith Bom & Pieter Bakx & Sara Rellstab, 2022. "Well‐being right before and after a permanent nursing home admission," Health Economics, John Wiley & Sons, Ltd., vol. 31(12), pages 2558-2574, December.
    9. Siciliani Luigi, 2013. "The Economics of Long-Term Care," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 14(2), pages 343-375, August.
    10. Atul Gupta & Sabrina T Howell & Constantine Yannelis & Abhinav Gupta, 2021. "Does Private Equity Investment in Healthcare Benefit Patients? Evidence from Nursing Homes," Working Papers 2021-20, Becker Friedman Institute for Research In Economics.
    11. Elena Gentili & Giuliano Masiero & Fabrizio Mazzonna, 2016. "The Role of Culture in Long-term Care," IdEP Economic Papers 1605, USI Università della Svizzera italiana.
    12. Sean Shenghsiu Huang & John R. Bowblis, 2018. "The principal–agent problem and owner‐managers: An instrumental variables application to nursing home quality," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1653-1669, November.
    13. Dauth, Christine & Lang, Julia, 2017. "Should the unemployed care for the elderly? : The effect of subsidized occupational and further training in elderly care," IAB-Discussion Paper 201713, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    14. Lianjie Wang & Yao Tang, 2023. "Changing Trends and the Effectiveness of Informal Care Among Rural Elderly Adults in China," SAGE Open, , vol. 13(4), pages 21582440231, October.
    15. Lang, Julia & Dauth, Christine, 2017. "Should the unemployed care for the elderly? The effect of subsidized occupational and further training in geriatric care," VfS Annual Conference 2017 (Vienna): Alternative Structures for Money and Banking 168130, Verein für Socialpolitik / German Economic Association.
    16. Bar, M.; & Bakx, P.; & Wouterse, B.; & van Doorslaer, Eddy.;, 2022. "Estimating the health value added by nursing homes," Health, Econometrics and Data Group (HEDG) Working Papers 22/12, HEDG, c/o Department of Economics, University of York.
    17. Bär, Marlies & Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy, 2022. "Estimating the health value added by nursing homes," Journal of Economic Behavior & Organization, Elsevier, vol. 203(C), pages 1-23.
    18. Crawford, Rowena & Stoye, George & Zaranko, Ben, 2021. "Long-term care spending and hospital use among the older population in England," Journal of Health Economics, Elsevier, vol. 78(C).
    19. 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.
    20. Rapp, Thomas & Ronchetti, Jérome & Sicsic, Jonathan, 2022. "Impact of formal care consumption on informal care use in Europe: What is happening at the beginning of dependency?," Health Policy, Elsevier, vol. 126(7), pages 632-642.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;

    JEL classification:

    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • I10 - Health, Education, and Welfare - - Health - - - General
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:hal:journl:hal-05460270. 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: CCSD (email available below). General contact details of provider: https://hal.archives-ouvertes.fr/ .

    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.