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Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment

Author

Listed:
  • T. Lehnert

    (University Medical Center Hamburg-Eppendorf)

  • O. H. Günther

    (University Medical Center Hamburg-Eppendorf)

  • A. Hajek

    (University Medical Center Hamburg-Eppendorf)

  • S. G. Riedel-Heller

    (University of Leipzig)

  • H. H. König

    (University Medical Center Hamburg-Eppendorf)

Abstract

Background Most people prefer to “age in place” and to remain in their homes for as long as possible even in case they require long-term care. While informal care is projected to decrease in Germany, the use of home- and community-based services (HCBS) can be expected to increase in the future. Preference-based data on aspects of HCBS is needed to optimize person-centered care. Objective To investigate preferences for home- and community-based long-term care services packages. Design Discrete choice experiment conducted in mailed survey. Setting and participants Randomly selected sample of the general population aged 45–64 years in Germany (n = 1.209). Main variables studied Preferences and marginal willingness to pay (WTP) for HCBS were assessed with respect to five HCBS attributes (with 2–4 levels): care time per day, service level of the HCBS provider, quality of care, number of different caregivers per month, co-payment. Results Quality of care was the most important attribute to respondents and small teams of regular caregivers (1–2) were preferred over larger teams. Yet, an extended range of services of the HCBS provider was not preferred over a more narrow range. WTP per hour of HCBS was €8.98. Conclusions Our findings on preferences for HCBS in the general population in Germany add to the growing international evidence of preferences for LTC. In light of the great importance of high care quality to respondents, reimbursement for services by HCBS providers could be more strongly linked to the quality of services.

Suggested Citation

  • T. Lehnert & O. H. Günther & A. Hajek & S. G. Riedel-Heller & H. H. König, 2018. "Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(9), pages 1213-1223, December.
    • Handle: RePEc:spr:eujhec:v:19:y:2018:i:9:d:10.1007_s10198-018-0968-0
    DOI: 10.1007/s10198-018-0968-0
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    Cited by:

    1. Kaambwa, Billingsley & Chen, Gang & Khadka, Jyoti & Milte, Rachel & Mpundu-Kaambwa, Christine & Woods, Taylor-Jade & Ratcliffe, Julie, 2021. "A preference for quality: Australian general public's willingness to pay for home and residential aged care," Social Science & Medicine, Elsevier, vol. 289(C).
    2. Chen, Gang & Ratcliffe, Julie & Milte, Rachel & Khadka, Jyoti & Kaambwa, Billingsley, 2021. "Quality of care experience in aged care: An Australia-Wide discrete choice experiment to elicit preference weights," Social Science & Medicine, Elsevier, vol. 289(C).
    3. Tongbo Deng & Yafan Fan & Mengdi Wu & Min Li, 2022. "Older People’s Long-Term Care Preferences in China: The Impact of Living with Grandchildren on Older People’s Willingness and Family Decisions," IJERPH, MDPI, vol. 19(19), pages 1-18, September.
    4. Walsh, Sharon & O'Shea, Eamon & Pierse, Tom & Kennelly, Brendan & Keogh, Fiona & Doherty, Edel, 2020. "Public preferences for home care services for people with dementia: A discrete choice experiment on personhood," Social Science & Medicine, Elsevier, vol. 245(C).
    5. Amilon, Anna & Kjær, Agnete Aslaug & Ladenburg, Jacob & Siren, Anu, 2022. "Trust in the publicly financed care system and willingness to pay for long-term care: A discrete choice experiment in Denmark," Social Science & Medicine, Elsevier, vol. 311(C).
    6. Lea de Jong & Torben Schmidt & Jona Theodor Stahmeyer & Sveja Eberhard & Jan Zeidler & Kathrin Damm, 2023. "Willingness to provide informal care to older adults in Germany: a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(3), pages 425-436, April.
    7. He, Alex Jingwei & Qian, Jiwei & Chan, Wai-sum & Chou, Kee-lee, 2021. "Preferences for private long-term care insurance products in a super-ageing society: A discrete choice experiment in Hong Kong," Social Science & Medicine, Elsevier, vol. 270(C).
    8. Lea de Jong & Jan Zeidler & Kathrin Damm, 2022. "A systematic review to identify the use of stated preference research in the field of older adult care," European Journal of Ageing, Springer, vol. 19(4), pages 1005-1056, December.

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    More about this item

    Keywords

    Preferences; Discrete choice experiment; Long-term care; Old age assistance;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I19 - Health, Education, and Welfare - - Health - - - Other

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