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The Influence of Spouse Ability to Provide Informal Care on Long-Term Care Use

27 Pages Posted: 13 Mar 2014  

Pieter Bakx

Erasmus University Rotterdam (EUR)

Claudine de Meijer

Erasmus MC

Date Written: April 13, 2013


Objective: Informal care substitutes for or postpones formal long-term care (LTC) use, especially in the Netherlands, where informal care supply affects eligibility for public LTC. The effect of potential informal care supply within the household has received less attention. We examine the role of spouse’s physical ability to provide informal care in explaining LTC use and transitions.

Method: We used Dutch respondents from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe. A mixed multinomial logit regression is used to model the choice between no LTC use, informal LTC use only, and formal LTC use. Transitions into formal care use are modeled with a logit regression.

Results: Spouse ability affects LTC use but living alone remains important after controlling for spouse ability. Other important determinants of use are having a child , age, disability and health status. Transitions are explained by informal care supply and changes therein, health and disability and the respondent’s age.

Discussion: Spouse ability to provide informal care reduces use of formal LTC, which implies that future compression of morbidity/disability and its impact would lower demand for LTC, directly and through increased spouse ability to provide informal care.

Keywords: aging, long-term care, informal care, disability

JEL Classification: I11, J14

Suggested Citation

Bakx, Pieter and de Meijer, Claudine, The Influence of Spouse Ability to Provide Informal Care on Long-Term Care Use (April 13, 2013). Available at SSRN: or

Pieter Bakx (Contact Author)

Erasmus University Rotterdam (EUR) ( email )


Claudine De Meijer

Erasmus MC ( email )

3000 DR Rotterdam

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