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The future of Long Term Care in Europe. An investigation using a dynamic microsimulation model

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Abstract

In this paper we investigate the evolution of public European LTC systems in the forthcoming decades, using the Europe Future Elderly Model (EuFEM), a dynamic microsimulation model which projects the health and socio-economic characteristics of the 50+ population of ten European countries, augmented with the explicit modelling of the eligibility rules of 5 countries. The use of SHARE data allows to have a better understanding of the trends in the demand for LTC differentiated by age groups, gender, and other demographic and social characteristics in order to better assess the distributional effects. We estimate the future potential coverage (or gap of coverage) of each national/regional public home-care system, and then disentangle the differences between countries in a population and a regulation effects. Our analysis offers new insights on how would the demand for LTC evolve over time, what would the distributional effects of different LTC policies be if no action is taken, and what could be potential impact of alternative care policies.

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  • Vincenzo Atella & Federico Belotti & Ludovico Carrino & Andrea Piano Mortari, 2017. "The future of Long Term Care in Europe. An investigation using a dynamic microsimulation model," CEIS Research Paper 405, Tor Vergata University, CEIS, revised 08 May 2017.
    • Handle: RePEc:rtv:ceisrp:405
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    1. Schokkaert, Erik & Van de Voorde, Carine, 2009. "Direct versus indirect standardization in risk adjustment," Journal of Health Economics, Elsevier, vol. 28(2), pages 361-374, March.
    2. 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.
    3. Dwyer, Debra Sabatini & Mitchell, Olivia S., 1999. "Health problems as determinants of retirement: Are self-rated measures endogenous?," Journal of Health Economics, Elsevier, vol. 18(2), pages 173-193, April.
    4. G�ng�r KARAKAYA, 2009. "Long-Term Care: Regional Disparities In Belgium," Journal of Applied Economic Sciences, Spiru Haret University, Faculty of Financial Management and Accounting Craiova, vol. 4(1(7)_ Spr).
    5. Ben Jann, 2007. "Making regression tables simplified," Stata Journal, StataCorp LP, vol. 7(2), pages 227-244, June.
    6. Francesca Colombo & Jérôme Mercier, 2012. "Help Wanted? Fair and Sustainable Financing of Long-term Care Services," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 34(2), pages 316-332.
    7. Francesca Colombo & Jérome Mercier, 2012. "Help Wanted? Fair and Sustainable Financing of Long-term Care Services," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 34(2), pages 316-332.
    8. Adriaan Kalwij & Giacomo Pasini & Mingqin Wu, 2014. "Home care for the elderly: the role of relatives, friends and neighbors," Review of Economics of the Household, Springer, vol. 12(2), pages 379-404, June.
    9. John Bound, 1991. "Self-Reported Versus Objective Measures of Health in Retirement Models," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 106-138.
    10. Esther Mot, 2010. "The Dutch system of long-term care," CPB Document 204.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    11. 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.
    12. Joan Costa-Font & Raphael Wittenberg & Concepció Patxot & Adelina Comas-Herrera & Cristiano Gori & Alessandra di Maio & Linda Pickard & Alessandro Pozzi & Heinz Rothgang, 2008. "Projecting Long-Term Care Expenditure in Four European Union Member States: The Influence of Demographic Scenarios," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 86(2), pages 303-321, April.
    13. Lynch, Jamie L. & von Hippel, Paul T., 2016. "An education gradient in health, a health gradient in education, or a confounded gradient in both?," Social Science & Medicine, Elsevier, vol. 154(C), pages 18-27.
    14. Kitty S. Chan & Judith D. Kasper & Jason Brandt & Liliana E. Pezzin, 2012. "Measurement Equivalence in ADL and IADL Difficulty Across International Surveys of Aging: Findings From the HRS, SHARE, and ELSA," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 67(1), pages 121-132.
    15. Sergi Jiménez-Martín & Cristina Prieto, 2012. "The trade-off between formal and informal care in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 461-490, August.
    16. Peña-Longobardo, Luz María & Oliva-Moreno, Juan & García-Armesto, Sandra & Hernández-Quevedo, Cristina, 2016. "The Spanish long-term care system in transition: Ten years since the 2006 Dependency Act," Health Policy, Elsevier, vol. 120(10), pages 1177-1182.
    17. Claudine Meijer & Pieter Bakx & Eddy Doorslaer & Marc Koopmanschap, 2015. "Explaining Declining Rates of Institutional LTC Use in the Netherlands: A Decomposition Approach," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 18-31, March.
    18. Anne Case & Angua Deaton, 2015. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century," Working Papers 15078.full.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    19. Hugh Gravelle, 2003. "Measuring income related inequality in health: standardisation and the partial concentration index," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 803-819, October.
    20. de Meijer, Claudine & Koopmanschap, Marc & d' Uva, Teresa Bago & van Doorslaer, Eddy, 2011. "Determinants of long-term care spending: Age, time to death or disability?," Journal of Health Economics, Elsevier, vol. 30(2), pages 425-438, March.
    21. Esther Mot, 2010. "The Dutch system of long-term care," CPB Document 204, CPB Netherlands Bureau for Economic Policy Analysis.
    22. Ludovico Carrino & Cristina Elisa Orso, 2014. "Eligibility and inclusiveness of Long-Term Care Institutional frameworks in Europe: a cross-country comparison," Working Papers 2014:28, Department of Economics, University of Venice "Ca' Foscari".
    23. Jinjing Li & Cathal O'Donoghue, 2013. "A survey of dynamic microsimulation models: uses, model structure and methodology," International Journal of Microsimulation, International Microsimulation Association, vol. 6(2), pages 3-55.
    24. 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.
    25. Erika Schulz, 2010. "The Long-Term Care System in Denmark," Discussion Papers of DIW Berlin 1038, DIW Berlin, German Institute for Economic Research.
    26. Mitchell P. LaPlante, 2010. "The Classic Measure of Disability in Activities of Daily Living Is Biased by Age but an Expanded IADL/ADL Measure Is Not," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 65(6), pages 720-732.
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    Cited by:

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    2. Giordana, Gastón A. & Pi Alperin, María Noel, 2023. "Old age takes its toll: Long-run projections of health-related public expenditure in Luxembourg," Economics & Human Biology, Elsevier, vol. 50(C).
    3. Sergei Kovbasyuk & Giancarlo Spagnolo, 2016. "Memory and Markets," EIEF Working Papers Series 1606, Einaudi Institute for Economics and Finance (EIEF), revised Oct 2017.
    4. Abbygail Jaccard & Lise Retat & Martin Brown & Laura Webber & Zaid Chalabi, 2018. "Global Sensitivity Analysis of a Model Simulating an Individual’s Health State through Their Lifetime," International Journal of Microsimulation, International Microsimulation Association, vol. 11(3), pages 100-121.

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    More about this item

    Keywords

    Dynamic Microsimulation; Long Term Care; Forecast; disability; Regulation;
    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
    • C53 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Forecasting and Prediction Models; Simulation Methods
    • C63 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Computational Techniques
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts

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