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Income‐rich and wealth‐poor? The impact of measures of socio‐economic status in the analysis of the distribution of long‐term care use among older people

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  • Ricardo Rodrigues
  • Stefania Ilinca
  • Andrea E. Schmidt

Abstract

This article aims to investigate the impact of using 2 measures of socio‐economic status on the analysis of how informal care and home care use are distributed among older people living in the community. Using data from the Survey of Health, Ageing and Retirement in Europe for 14 European countries, we estimate differences in corrected concentration indices for use of informal care and home care, using equivalised household net income and equivalised net worth (as a proxy for wealth). We also calculate horizontal inequity indices using both measures of socio‐economic status and accounting for differences in need. The findings show that using wealth as a ranking variable results, as a rule, in a less pro‐poor inequality of use for both informal and home care. Once differences in need are controlled for (horizontal inequity), wealth still results in a less pro‐poor distribution for informal care, in comparison with income, whereas the opposite is observed for home care. Possible explanations for these differences and research and policy implications are discussed.

Suggested Citation

  • Ricardo Rodrigues & Stefania Ilinca & Andrea E. Schmidt, 2018. "Income‐rich and wealth‐poor? The impact of measures of socio‐economic status in the analysis of the distribution of long‐term care use among older people," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 637-646, March.
    • Handle: RePEc:wly:hlthec:v:27:y:2018:i:3:p:637-646
    DOI: 10.1002/hec.3607
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    2. Javier Lera & Marta Pascual-Sáez & David Cantarero-Prieto, 2020. "Socioeconomic Inequality in the Use of Long-Term Care among European Older Adults: An Empirical Approach Using the SHARE Survey," IJERPH, MDPI, vol. 18(1), pages 1-14, December.
    3. Zhonghua Wang & Xue Yang & Mingsheng Chen, 2022. "Inequality and Associated Factors in Utilization of Long-Term Care Among Chinese Older People: Evidence from the Chinese Longitudinal Healthy Longevity Survey," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 467-486, April.
    4. Fuino, Michel & Wagner, Joël, 2020. "Duration of long-term care: Socio-economic factors, type of care interactions and evolution," Insurance: Mathematics and Economics, Elsevier, vol. 90(C), pages 151-168.
    5. Pilar (P.) Garcia-Gomez & Helena M Hernandez-Pizarro & Guillem Lopez-Casasnovas & Joaquim Vidiella-Martin, 2019. "Unravelling Hidden Inequities in a Universal Public Long-Term Care System," Tinbergen Institute Discussion Papers 19-011/V, Tinbergen Institute.
    6. Marianne Tenand & Pieter Bakx & Eddy van Doorslaer, 2020. "Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 435-451, April.
    7. Tran, My & Gannon, Brenda & Rose, Christiern, 2023. "The effect of housing wealth on older adults’ health care utilization: Evidence from fluctuations in the U.S. housing market," Journal of Health Economics, Elsevier, vol. 88(C).
    8. Guangbo Ma & Kun Xu, 2022. "Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health," IJERPH, MDPI, vol. 20(1), pages 1-20, December.

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