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Trade-off between formal and informal care in Spain

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Abstract

The remarkable growth of older population has moved long term care to the front ranks of the social policy agenda. Understanding the factors that determine the type and amount of formal care is important for predicting use in the future and developing long-term policy. In this context we jointly analyze the choice of care (formal, informal, both together or none) as well as the number of hours of care received. Given that the number of hours of care is not independent of the type of care received, we estimate, for the first time in this area of research, a sample selection model with the particularity that the first step is a multinomial logit model. With regard to the debate about complementarity or substitutability between formal and informal care, our results indicate that formal care acts as a reinforcement of the family care in certain cases: for very old care receivers, in those cases in which the individual has multiple disabilities, when many care hours are provided, and in case of mental illness and/or dementia. There exist substantial differences in long term care addressed to younger and older dependent people and dependent women are in risk of becoming more vulnerable to the shortage of informal caregivers in the future. Finally, we have documented that there are great disparities in the availability of public social care across regions.

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  • Sergi Jiménez-Martín & Cristina Vilaplana Prieto, 2008. "Trade-off between formal and informal care in Spain," Economics Working Papers 1096, Department of Economics and Business, Universitat Pompeu Fabra.
  • Handle: RePEc:upf:upfgen:1096
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    1. Raúl Del Pozo-Rubio & Pablo Moya-Martínez & Marta Ortega-Ortega & Juan Oliva-Moreno, 2020. "Shadow and extended shadow cost sharing associated to informal long-term care: the case of Spain," Health Economics Review, Springer, vol. 10(1), pages 1-12, December.
    2. Karine Chevreul & Coralie Gandré & Karen Berg Brigham & Julio López-Bastida & Renata Linertová & Juan Oliva-Moreno & Pedro Serrano-Aguilar & Manuel Posada-de-la-Paz & Domenica Taruscio & Arrigo Schiep, 2016. "Social/economic costs and health-related quality of life in patients with fragile X syndrome in Europe," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(1), pages 43-52, April.
    3. Ludovico Carrino & Cristina Elisa Orso, 2014. "Eligibility and inclusiveness of Long-Term Care Institutional frameworks in Europe: a cross-country comparison," Working Papers 2014:28, Department of Economics, University of Venice "Ca' Foscari".
    4. Torbica, Aleksandra & Calciolari, Stefano & Fattore, Giovanni, 2015. "Does informal care impact utilization of healthcare services? Evidence from a longitudinal study of stroke patients," Social Science & Medicine, Elsevier, vol. 124(C), pages 29-38.
    5. Matthias Firgo & Klaus Nowotny & Alexander Braun, 2020. "Informal, formal, or both? Assessing the drivers of home care utilization in Austria using a simultaneous decision framework," Applied Economics, Taylor & Francis Journals, vol. 52(40), pages 4440-4456, August.
    6. Vincenzo Atella & Federico Belotti & Ludovico Carrino & Andrea Piano Mortari, 2017. "The future of Long Term Care in Europe. An investigation using a dynamic microsimulation model," CEIS Research Paper 405, Tor Vergata University, CEIS, revised 08 May 2017.
    7. Florentino Felgueroso & Angel de la Fuente & José E. Boscá & Joan Costa i Font & Rafael Doménech & Javier Ferri & José I. García Pérez & Sergi Jiménez & Diego Rodríguez & Analía Viola, 2020. "Aspectos económicos de la crisis del Covid-19. Boletín de seguimiento nº2," Studies on the Spanish Economy eee2020-14, FEDEA.
    8. Matthias Firgo & Klaus Nowotny & Alexander Braun, 2017. "Austria 2025 – Informal, Formal, or Both? Assessing the Drivers of Home Care Utilisation in Austria Using a Simultaneous Decision Framework," WIFO Studies, WIFO, number 59741.
    9. L. M. Peña-Longobardo & B. Rodríguez-Sánchez & J. Oliva-Moreno & I. Aranda-Reneo & J. López-Bastida, 2019. "How relevant are social costs in economic evaluations? The case of Alzheimer’s disease," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(8), pages 1207-1236, November.
    10. Bauer, Jan Michael & Sousa-Poza, Alfonso, 2015. "Impacts of Informal Caregiving on Caregiver Employment, Health, and Family," IZA Discussion Papers 8851, Institute of Labor Economics (IZA).
    11. Zhang, Wei & Sun, Huiying & L'Heureux, Jacynthe, 2021. "Substitutes or complements between informal and formal home care in the Canadian longitudinal study on aging: Functional impairment as an effect modifier," Health Policy, Elsevier, vol. 125(9), pages 1267-1275.
    12. Juan Oliva-Moreno & Luz María Peña-Longobardo & Leticia García-Mochón & María del Río Lozano & Isabel Mosquera Metcalfe & María del Mar García-Calvente, 2019. "The economic value of time of informal care and its determinants (The CUIDARSE Study)," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-15, May.
    13. García-Gómez, Pilar & Hernández-Quevedo, Cristina & Jiménez-Rubio, Dolores & Oliva-Moreno, Juan, 2015. "Inequity in long-term care use and unmet need: Two sides of the same coin," Journal of Health Economics, Elsevier, vol. 39(C), pages 147-158.
    14. Matus-López, Mauricio & Rodríguez-Modroño, Paula & Gálvez-Muñoz, Lina, 2018. "Assessing the impact of austerity on care jobs. The case of the Spanish long-term care system," MPRA Paper 105441, University Library of Munich, Germany.
    15. David Cantarero & Marta Pascual & Beatriz Rodríguez-Sánchez, 2022. "Differences in the Use of Formal and Informal Care Services among Older Adults after the Implementation of the Dependency Act in Spain," Hacienda Pública Española / Review of Public Economics, IEF, vol. 240(1), pages 61-93, March.
    16. Oleguer Parés-Badell & Gabriela Barbaglia & Petra Jerinic & Anders Gustavsson & Luis Salvador-Carulla & Jordi Alonso, 2014. "Cost of Disorders of the Brain in Spain," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-10, August.
    17. Courtin, Emilie & Jemiai, Nadia & Mossialos, Elias, 2014. "Mapping support policies for informal carers across the European Union," Health Policy, Elsevier, vol. 118(1), pages 84-94.
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    19. Sergi Jiménez-Martín & Analía Viola, 2020. "La asistencia residencial en España y COVID-19," Studies on the Spanish Economy eee2020-20, FEDEA.
    20. Ulrike Famira-Mühlberger & Matthias Firgo, 2018. "Aktuelle und künftige Versorgungsfunktion der mobilen Pflege- und Betreuungsdienste in Österreich," WIFO Studies, WIFO, number 61563.
    21. Elisabeth Fevang & Snorre Kverndokk & Knut Røed, 2012. "Labor supply in the terminal stages of lone parents’ lives," Journal of Population Economics, Springer;European Society for Population Economics, vol. 25(4), pages 1399-1422, October.
    22. Heger, Dörte & Korfhage, Thorben, 2016. "Care choices in Europe: To each according to his needs?," Ruhr Economic Papers 649, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.

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    More about this item

    Keywords

    Formal care; informal care; caregiver; dependent;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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