Reaching the consumer: importance of travel costs in home care provision

Providing care at home generates specific constraints, particularly the travel of caregivers to the consumers’ place. This paper analyzes the empirical significance of travel costs in the context of home care provision in France, expliciting the sources of their variation and their effect on the organization of providers. It makes use of original data obtained from a large home care provider. Travel time and distance generated by caregiver rounds are computed from geographical information in the data, to retrieve the travel costs borne by the provider. They are found to be higher in rural municipalities and to decrease with the size of urban units. This is due higher travel distances but also to the characteristics of the demand living there. Indeed, severely disabled individuals are over-represented in these areas and their fragmented consumption generates higher travel costs. In this context, the unique price charged to all consumers entails a redistribution towards rural areas and disabled individuals. The travel costs are found to have a limited effect on the duration of interventions.