Demand of Long-Term Care and Benefit Eligibility Across European Countries

35 Pages Posted: 5 Sep 2015

See all articles by Ludovico Carrino

Ludovico Carrino

King's College London; Ca Foscari University of Venice - Dipartimento di Economia

Cristina Orso

Ca Foscari University of Venice - Dipartimento di Economia

Giacomo Pasini

Ca' Foscari University of Venice; Netspar

Date Written: August 27, 2015

Abstract

In the context of an unprecedented aging process, the role of domiciliary care for older adults is becoming increasingly essential. In order to design effective and proactive policies of formal elderly-care, it is crucial to understand how vulnerable elderly individuals would adjust their informal long-term care utilization to changes in the formal-care provision. Although theoretical frameworks have been proposed, showing that a positive relationship could arise when the elderly exhibit an excess demand of care, empirical evidence is scant, due to the lack of credible instruments to account for the endogenous nature of formal-care decisions. We propose a novel instrument, an index that capture individuals’ eligibility status to the LTC domiciliary programmes implemented in their own nation or region. That is, a dummy variable - being eligible or not - which is grounded on the LTC regulation context at national or regional level, but still has individual within region variation due to differences in health conditions and vulnerability assessment. We estimate an IV two-part model using a representative sample of the over 60 population for non-institutionalised individuals in Austria, Germany, France and Belgium. Our results, which are robust to a number of different specifications, point at the lack of crowding-out of the informal- by the formal-care, thus suggesting the existence of a substantial unmet demand of LTC among the elderly.

Keywords: home care, instrumental variables, unmet demand, SHARE data

JEL Classification: C36, I13, J14

Suggested Citation

Carrino, Ludovico and Orso, Cristina and Pasini, Giacomo, Demand of Long-Term Care and Benefit Eligibility Across European Countries (August 27, 2015). University Ca' Foscari of Venice, Dept. of Economics Working Paper Series No. 26/WP/2015. Available at SSRN: https://ssrn.com/abstract=2655729 or http://dx.doi.org/10.2139/ssrn.2655729

Ludovico Carrino (Contact Author)

King's College London ( email )

Room D11, East Wing
Strand Campus
London, WC2R 2LS
United Kingdom

HOME PAGE: http://https://kclpure.kcl.ac.uk/portal/ludovico.carrino.html

Ca Foscari University of Venice - Dipartimento di Economia ( email )

Cannaregio 873
Venice, 30121
Italy

Cristina Orso

Ca Foscari University of Venice - Dipartimento di Economia ( email )

Cannaregio 873
Venice, 30121
Italy

Giacomo Pasini

Ca' Foscari University of Venice ( email )

Cannaregio 873
Venice, 30121
Italy
+39 041 234 9171 (Phone)
+39 041 2349176 (Fax)

HOME PAGE: http://https://sites.google.com/unive.it/pasini

Netspar ( email )

P.O. Box 90153
Tilburg, 5000 LE
Netherlands

HOME PAGE: http://www.netspar.nl/people/researchfellows/pasini/

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