Affiliation:
1. Department of Global Health & Social Medicine, King’s College London
Abstract
Abstract
Objectives
We examine whether socioeconomic inequalities in home-care use among disabled older adults are related to the contextual characteristics of long-term care (LTC) systems. Specifically, we investigate how wealth and income gradients in the use of informal, formal, and mixed home-care vary according to the degree to which LTC systems offer alternatives to families as the main providers of care (“de-familization”).
Method
We use survey data from SHARE on disabled older adults from 136 administrative regions in 12 European countries and link them to a regional indicator of de-familization in LTC, measured by the number of available LTC beds in care homes. We use multinomial multilevel models, with and without country fixed-effects, to study home-care use as a function of individual-level and regional-level LTC characteristics. We interact financial wealth and income with the number of LTC beds to assess whether socioeconomic gradients in home-care use differ across regions according to the degree of de-familization in LTC.
Results
We find robust evidence that socioeconomic status inequalities in the use of mixed-care are lower in more de-familized LTC systems. Poorer people are more likely than the wealthier to combine informal and formal home-care use in regions with more LTC beds. SES inequalities in the exclusive use of informal or formal care do not differ by the level of de-familization.
Discussion
The results suggest that de-familization in LTC favors the combination of formal and informal home-care among the more socioeconomically disadvantaged, potentially mitigating health inequalities in later life.
Funder
Economic and Social Research Council
Publisher
Oxford University Press (OUP)
Subject
Geriatrics and Gerontology,Gerontology,Clinical Psychology,Social Psychology
Reference39 articles.
1. Demography of informal caregiving;Agree,2009
2. Unequal inequalities: The stratification of the use of formal care among older Europeans;Albertini;The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences,2017
3. Societal and individual determinants of medical care utilization in the United States;Andersen;Milbank Quarterly,2005
4. Going formal or informal, who cares? The influence of public long-term care insurance;Bakx;Health Economics,2015
5. Elasticities and the inverse hyperbolic sine transformation;Bellemare;Oxford Bulletin of Economics and Statistics,2020
Cited by
22 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献