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Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival

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  • Bakx, Pieter
  • Wouterse, Bram
  • van Doorslaer, Eddy
  • Wong, Albert

Abstract

Encouraging and helping elderly to postpone a nursing home admission appears to be a win-win that keeps long-term care spending in check and is in line with the target population’s preferences, but there is little evidence about its effects. We study the causal impact of nursing home admission eligibility using Dutch administrative data and exploiting variation between randomly assigned assessors in their tendency to grant eligibility for a nursing home admission. We find a drop in medical care use when eligibility is granted, especially in hospital admissions, while total healthcare spending is unaffected. This suggests that postponing an admission may not always be a win-win after all.

Suggested Citation

  • Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    • Handle: RePEc:eee:jhecon:v:73:y:2020:i:c:s0167629619307635
    DOI: 10.1016/j.jhealeco.2020.102354
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 5th October 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-10-05 11:00:05

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    Cited by:

    1. Judith Bom & Pieter Bakx & Sara Rellstab, 2022. "Well‐being right before and after a permanent nursing home admission," Health Economics, John Wiley & Sons, Ltd., vol. 31(12), pages 2558-2574, December.
    2. Jakob D’herde & Wesley Gruijthuijsen & Dominique Vanneste & Veerle Draulans & Hilde Heynen, 2021. "“I Could Not Manage This Long-Term, Absolutely Not.” Aging in Place, Informal Care, COVID-19, and the Neighborhood in Flanders (Belgium)," IJERPH, MDPI, vol. 18(12), pages 1-14, June.
    3. Stöckel, Jannis & Bom, Judith, 2022. "Revisiting longer-term health effects of informal caregiving: Evidence from the UK," The Journal of the Economics of Ageing, Elsevier, vol. 21(C).
    4. Bom, Judith & Stöckel, Jannis, 2021. "Is the grass greener on the other side? The health impact of providing informal care in the UK and the Netherlands," Social Science & Medicine, Elsevier, vol. 269(C).
    5. Xavier Flawinne & Mathieu Lefebvre & Sergio Perelman & Pierre Pestieau & Jérôme Schoenmaeckers, 2023. "Nursing homes and mortality in Europe: Uncertain causality," Health Economics, John Wiley & Sons, Ltd., vol. 32(1), pages 134-154, January.
    6. Moura, Ana, 2021. "Essays in health economics," Other publications TiSEM c93abd22-fa4a-42a5-b172-d, Tilburg University, School of Economics and Management.
    7. Bram Wouterse & Arjen Hussem & Albert Wong, 2022. "The risk protection and redistribution effects of long‐term care co‐payments," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 89(1), pages 161-186, March.
    8. Francisca Vargas Lopes & Pieter Bakx & Sam Harper & Bastian Ravesteijn & Tom Van Ourti, 2022. "The effects of supported housing for individuals with mental disorders," Health Economics, John Wiley & Sons, Ltd., vol. 31(S2), pages 115-133, October.
    9. Moura, Ana, 2022. "Do subsidized nursing homes and home care teams reduce hospital bed-blocking? Evidence from Portugal," Journal of Health Economics, Elsevier, vol. 84(C).
    10. Serrano-Alarcón, Manuel & Hernández-Pizarro, Helena & López-Casasnovas, Guillem & Nicodemo, Catia, 2022. "Effects of long-term care benefits on healthcare utilization in Catalonia," Journal of Health Economics, Elsevier, vol. 84(C).
    11. Crawford, Rowena & Stoye, George & Zaranko, Ben, 2021. "Long-term care spending and hospital use among the older population in England," Journal of Health Economics, Elsevier, vol. 78(C).
    12. Hollingsworth, Bruce & Ohinata, Asako & Picchio, Matteo & Walker, Ian, 2022. "Does It Matter Who Cares for You? The Effect of Substituting Informal with Formal Personal Care on the Care Recipients' Health," IZA Discussion Papers 15457, Institute of Labor Economics (IZA).
    13. Almuhaisen, Abdulmohsen & Amuedo-Dorantes, Catalina & Furtado, Delia, 2024. "Immigration enforcement and the institutionalization of elderly Americans," Journal of Health Economics, Elsevier, vol. 94(C).
    14. Bonekamp, Johan & Wouterse, Bram, 2023. "Do different shocks in health matter for wealth?," Journal of Health Economics, Elsevier, vol. 87(C).
    15. Manuel Serrano-Alarcón & Helena Hernández-Pizarro & Guillem López i Casasnovas & Catia Nicodemo, 2021. "The effect of Long-Term Care (LTC) benefits on healthcare use," Working Papers 2021-12, FEDEA.
    16. Walsh, Brendan & Lyons, Seán, 2021. "Demand for the Statutory Home Care Scheme," Research Series, Economic and Social Research Institute (ESRI), number RS122.
    17. Bergeot, Julien & Tenand, Marianne, 2023. "Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data," Journal of Health Economics, Elsevier, vol. 92(C).

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    More about this item

    Keywords

    Long-term care; Policy evaluation; Instrumental variables;
    All these keywords.

    JEL classification:

    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation
    • I10 - Health, Education, and Welfare - - Health - - - General

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