Unravelling Hidden Inequities in a Universal Public Long-Term Care System

Tinbergen Institute Discussion Papers 2019-011/V

36 Pages Posted: 14 Feb 2019 Last revised: 21 Feb 2019

See all articles by Pilar Garcia-Gomez

Pilar Garcia-Gomez

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE)

Helena M Hernandez-Pizarro

Universitat Pompeu Fabra - Department of Economics and Business

Guillem Lopez Casasnovas

Universitat Pompeu Fabra - Faculty of Economic and Business Sciences

Joaquim Vidiella-Martin

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE)

Date Written: January 29, 2019

Abstract

We investigate whether publicly subsidized long-term care (LTC) is allocated according to needs, independently from income, using administrative data from all applicants for public LTC in Catalonia, from 2011 to 2014. We measure the level of horizontal inequity in subsidies to compensate informal care costs, formal home care, and institutional care using objective detailed information on needs. Our findings suggest that the system is inequitable; cash transfers are distributed among the financially better-off, while the use of nursing homes is concentrated among the worse-off. Additionally, we assess the inequity in the form of provision (voucher versus in- kind) and its implications for the equity in the time to access. Our results show that while in-kind provision is concentrated among the worse-off, the better-off are more likely to receive a voucher to (partly) subsidize LTC expenses. However, this duality does not imply inequity in the time to access a nursing home.

Keywords: long-term care, equity, public provision, voucher, in-kind

JEL Classification: I14, I38, J14

Suggested Citation

Garcia Gomez, Pilar and Hernandez-Pizarro, Helena M and Lopez Casasnovas, Guillem and Vidiella-Martin, Joaquim, Unravelling Hidden Inequities in a Universal Public Long-Term Care System (January 29, 2019). Tinbergen Institute Discussion Papers 2019-011/V. Available at SSRN: https://ssrn.com/abstract=3329198 or http://dx.doi.org/10.2139/ssrn.3329198

Pilar Garcia Gomez (Contact Author)

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE) ( email )

P.O. Box 1738
3000 DR Rotterdam, NL 3062 PA
Netherlands

Helena M Hernandez-Pizarro

Universitat Pompeu Fabra - Department of Economics and Business ( email )

Barcelona
Spain

Guillem Lopez Casasnovas

Universitat Pompeu Fabra - Faculty of Economic and Business Sciences ( email )

Ramon Trias Fargas 25-27
Barcelona, 08005
Spain

Joaquim Vidiella-Martin

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE) ( email )

P.O. Box 1738
3000 DR Rotterdam, NL 3062 PA
Netherlands

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