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Caring Connections in Italy: The Role of Immigrant Caregivers in Improving the Welfare of Elders and Reducing Public Health Costs

Author

Listed:
  • Capretti, Lisa

    (University of Rome Tor Vergata)

  • Kopinska, Joanna

    (Sapienza University of Rome)

  • Mariani, Rama Dasi

    (Roma Tre University)

  • Rosati, Furio C.

    (University of Rome Tor Vergata)

Abstract

We examine the impact of migrant-provided home-based care on elderly health in Italy, focusing on hospitalisation frequency, length of stay, and mortality. To address potential endogeneity between local health conditions and immigrant settlement , we use an instrumental variable approach. Our results show that an higer supply of migrant caregivers reduces both the frequency (extensive margin) and duration (intensive margin) of hospital admissions. One percentage point increase in the immigrant-to-elderly population ratio leads to a 4% decline in long-term and rehabilitation inpatient admissions, with no effect on acute inpatient. We also find a 1.5% reduction in average admission duration, rising to 3.3% for LRI cases. These effects are primarily driven by diagnoses related to traumatic injuries, musculoskeletal and genitourinary conditions—areas closely linked to home-based mobility and care management. Back-of-the-envelope calculations suggest that the observed 1.3 percentage point average annual increase in the migrant-to-elderly ratio during our study period corresponds to an estimated 9% reduction in elderly LRI hospitalisation costs, yielding annual public savings of approximately 0.66% of total hospitalisation expenditures.

Suggested Citation

  • Capretti, Lisa & Kopinska, Joanna & Mariani, Rama Dasi & Rosati, Furio C., 2025. "Caring Connections in Italy: The Role of Immigrant Caregivers in Improving the Welfare of Elders and Reducing Public Health Costs," IZA Discussion Papers 18188, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp18188
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    References listed on IDEAS

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    1. Yarine Fawaz & Pedro Mira, 2023. "Social isolation, health dynamics, and mortality: evidence across 21 European countries," Journal of Population Economics, Springer;European Society for Population Economics, vol. 36(4), pages 2483-2518, October.
    2. J. Bradford Rice & Judith D. Kasper & Liliana E. Pezzin, 2009. "A comparative analysis of Medicaid long‐term care policies and their effects on elderly dual enrollees," Health Economics, John Wiley & Sons, Ltd., vol. 18(3), pages 275-290, March.
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    Keywords

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    JEL classification:

    • F22 - International Economics - - International Factor Movements and International Business - - - International Migration
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

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