What composes desirable formal at-home elder care? An analysis for multiple service combinations

Abstract

AbstractI estimate the relationship between combinations of multiple services for formal at-home elder care and health status. As a reasonable substitute for expensive institutional care, at-home formal elderly care is gaining popularity in developed countries. Because at-home care is composed of many small and complementary services, the relationship between multiple service combinations and health status requires analysis. However, the high dimensionality of these combinations makes estimation difficult. This study employs a regression analysis using care service combinations as cross-dummy explanatory variables. To reduce the combination dimensions, I select the combinations that are purchased jointly by a sufficient number of the elderly using basket analysis. I apply this method to claims data for Japanese long-term care, for which the social insurance program has resulted in the emergence of a market that offers many care services for the elderly. The empirical results show that only 200 combinations of 14 at-home care services are used by more than 0.03% of the insured in Japan. Of these combinations, rehabilitation services have a considerable positive correlation with the health status of the elderly. However, their use is limited owing to regional disparities in the location of such services.