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Proximity to death and participation in the long‐term care market
Author(s) -
Weaver France,
Stearns Sally C.,
Norton Edward C.,
Spector William
Publication year - 2009
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.1409
Subject(s) - long term care , residence , marital status , demographic economics , institutionalisation , life expectancy , demography , per capita , term (time) , probit model , gerontology , economics , medicine , nursing , sociology , population , physics , quantum mechanics , psychiatry , econometrics
Abstract The extent to which increasing longevity increases per capita demand for long‐term care depends on the degree to which utilization is concentrated at the end of life. We estimate the marginal effect of proximity to death, measured by being within 2 years of death, on the probabilities of nursing home and formal home care use, and we determine whether this effect differs by availability of informal care – i.e. marital status and co‐residence with an adult child. The analysis uses a sample of elderly aged 70+from the 1993–2002 Health and Retirement Study. Simultaneous probit models address the joint decisions to use long‐term care and co‐reside with an adult child. Overall, proximity to death significantly increases the probability of nursing home use by 50.0% and of formal home care use by 12.4%. Availability of informal support significantly reduces the effect of proximity to death. Among married elderly, proximity to death has no effect on institutionalization. In conclusion, proximity to death is one of the main drivers of long‐term care use, but changes in sources of informal support, such as an increase in the proportion of married elderly, may lessen its importance in shaping the demand for long‐term care. Copyright © 2008 John Wiley & Sons, Ltd.