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财富与长期护理服务的利用:来自美国的证据。

Wealth and the utilization of long-term care services: evidence from the United States.

机构信息

University of Chicago, Chicago, USA.

IMPAQ International, Columbia, USA.

出版信息

Int J Health Econ Manag. 2021 Sep;21(3):345-366. doi: 10.1007/s10754-021-09299-1. Epub 2021 Mar 30.

Abstract

Long-term care (LTC) provision and financing has become a major challenge for policymakers in the United States and worldwide. To inform associated policies and more efficiently allocate LTC resources, it is important to understand how demand for different types of LTC services responds to increased wealth. We use data from the United States Health and Retirement Study to examine the use of LTC services following plausibly exogenous positive shocks to wealth. We further account for time-invariant household-level characteristics, including the expectation of a wealth shock at an unknown future time, by employing household fixed effects. We find that large positive wealth shocks lead to a greater probability of purchase of paid home care but not of nursing home care. Our results imply that expanding home and community-based services and insurance coverage of home care for people without sufficient wealth is likely to be efficient and welfare improving and should be considered by policymakers.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 4 Given name: [R. Tamara] Last name: [Konetzka]. Also, kindly confirm the details in the metadata are correct.confirmedPlease confirm the city are correct and amend if necessary in Affiliations 1, 2, 3, 4.confirmed.

摘要

长期护理(LTC)的提供和融资已成为美国和全球政策制定者面临的主要挑战。为了为相关政策提供信息并更有效地分配长期护理资源,了解不同类型的长期护理服务的需求如何对财富增加做出反应非常重要。我们使用来自美国健康与退休研究的数据,考察了在财富受到明显外生正向冲击后对长期护理服务的使用情况。我们进一步通过家庭固定效应考虑了家庭层面不变的特征,包括对未来未知时间的财富冲击的预期。我们发现,大额正向财富冲击会导致购买付费家庭护理的可能性增加,但不会导致购买疗养院护理的可能性增加。我们的结果表明,扩大家庭和社区为基础的服务以及为没有足够财富的人提供家庭护理的保险覆盖范围可能是有效和提高福利的,政策制定者应该考虑这一点。

请确认作者姓名是否准确无误地按正确的顺序(名、中间名/首字母、姓)呈现。作者 4 名:[R. Tamara] 姓:[Konetzka]。此外,请确认元数据中的详细信息是否正确。

请确认城市是否正确,如果有必要,请在第 1、2、3、4 个隶属关系中进行修正。确认。

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