Abstract
AbstractDepending on their place of residence, older persons have unequal access to long-term care (LTC) services. This article investigates how the county-level supply of inpatient and outpatient LTC services influences individual-level LTC choices of older persons. Administrative data on LTC service supply from the German Care Statistic are combined with representative survey data on the LTC choices of N = 1303 persons aged 80+ from the German Federal State North Rhine-Westphalia. Random utility models are applied to model the choice among three care arrangements: receiving inpatient care in an institutional setting (e.g., nursing home), receiving outpatient care in the community, and living in the community without receiving inpatient or outpatient care. The main findings are: Higher inpatient service supply increases the probability that older persons leave the community and enter institutional LTC. Higher outpatient service supply increases the probability that older persons choose to receive outpatient care in the community instead of entering institutional LTC. The results suggest that policy makers must consider the county-level LTC service supply when designing equitable LTC systems that meet the needs of older persons in a cost-effective way.
Publisher
Springer Science and Business Media LLC
Subject
Sociology and Political Science,Geography, Planning and Development,Demography
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