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Crowding out Informal Care? Evidence from a Social Experiment in Germany

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  • Arntz, Melanie
  • Thomsen, Stephan L.

Abstract

This paper evaluates the effects of a professionally assisted consumer-directed program (Personal Budgets) compared to the standard home care programs of the German long-term care insurance. The evaluation makes use of a long-run social experiment at seven different sites with a random assignment into a treatment group receiving personal budgets and a control group in standard home care programs, i.e. an in-kind benefit (agency care) and cash payments. Compared to agency care personal budgets yield better care outcomes with regard to the overall support of formal and informal caregivers. In contrast, personal budgets do not improve care outcomes compared to the much less generous cash payments due to a strong crowding out of informal by formal care.

Suggested Citation

  • Arntz, Melanie & Thomsen, Stephan L., 2008. "Crowding out Informal Care? Evidence from a Social Experiment in Germany," ZEW Discussion Papers 08-113, ZEW - Leibniz Centre for European Economic Research.
  • Handle: RePEc:zbw:zewdip:7503
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    References listed on IDEAS

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    1. Donges, Juergen B. & Eekhoff, Johann & Franz, Wolfgang & Fuest, Clemens & Möschel, Wernhard & Neumann, Manfred J. M., 2005. "Tragfähige Pflegeversicherung," Kronberger Kreis-Studien 42, Stiftung Marktwirtschaft / The Market Economy Foundation, Berlin.
    2. James J. Heckman & Jeffrey A. Smith, 1995. "Assessing the Case for Social Experiments," Journal of Economic Perspectives, American Economic Association, vol. 9(2), pages 85-110, Spring.
    3. Liliana E. Pezzin & Peter Kemper & James Reschovsky, 1996. "Does Publicly Provided Home Care Substitute for Family Care? Experimental Evidence with Endogenous Living Arrangements," Journal of Human Resources, University of Wisconsin Press, vol. 31(3), pages 650-676.
    4. Vernon L. Greene & Mary E. Lovely & Jan I. Ondrich, 1993. "Do Community-Based, Long-Term-Care Services Reduce Nursing Home Use? A Transition Probability Analysis," Journal of Human Resources, University of Wisconsin Press, vol. 28(2), pages 297-317.
    5. Ettner, Susan L, 1994. "The Effect of the Medicaid Home Care Benefit on Long-Term Care Choices of the Elderly," Economic Inquiry, Western Economic Association International, vol. 32(1), pages 103-127, January.
    6. Jeffrey Smith, 2000. "A Critical Survey of Empirical Methods for Evaluating Active Labor Market Policies," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 136(III), pages 247-268, September.
    7. Jasmin Häcker & Bernd Raffelhüschen, 2004. "Denn sie wussten, was sie taten: zur Reform der Sozialen Pflegeversicherung," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 73(1), pages 158-174.
    8. Bijwaard, Govert E. & Ridder, Geert, 2005. "Correcting for selective compliance in a re-employment bonus experiment," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 77-111.
    9. Alberto Abadie, 2005. "Semiparametric Difference-in-Differences Estimators," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 1-19.
    10. Ashenfelter, Orley & Card, David, 1985. "Using the Longitudinal Structure of Earnings to Estimate the Effect of Training Programs," The Review of Economics and Statistics, MIT Press, vol. 67(4), pages 648-660, November.
    11. A. D. Roy, 1951. "Some Thoughts On The Distribution Of Earnings," Oxford Economic Papers, Oxford University Press, vol. 3(2), pages 135-146.
    12. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 31(3), pages 129-137.
    13. Oecd, 2006. "Projecting OECD Health and Long-Term Care Expenditures: What Are the Main Drivers?," OECD Economics Department Working Papers 477, OECD Publishing.
    14. repec:mpr:mprres:3503 is not listed on IDEAS
    15. Jens Lundsgaard, 2005. "Consumer Direction and Choice in Long-Term Care for Older Persons, Including Payments for Informal Care: How Can it Help Improve Care Outcomes, Employment and Fiscal Sustainability?," OECD Health Working Papers 20, OECD Publishing.
    16. Van Houtven, Courtney Harold & Norton, Edward C., 2008. "Informal care and Medicare expenditures: Testing for heterogeneous treatment effects," Journal of Health Economics, Elsevier, vol. 27(1), pages 134-156, January.
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    Cited by:

    1. Melanie Arntz & Stephan L. Thomsen, 2010. "The Social Long-term Care Insurance: A Frail Pillar of the German Social Insurance System," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 8(2), pages 29-34, 07.
    2. Arntz Melanie & Thomsen Stephan L., 2010. "Are Personal Budgets a Financially Sound Reform Option for the German Long-Term Care Insurance?," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 230(4), pages 378-402, August.
    3. Keck, Wolfgang, 2011. "Pflege und Beruf: Ungleiche Chancen der Vereinbarkeit," WZBrief Arbeit 09, WZB Berlin Social Science Center.
    4. repec:ces:ifodic:v:8:y:2010:i:2:p:14566976 is not listed on IDEAS
    5. Arntz, Melanie & Thomsen, Stephan L., 2008. "Reforming Home Care Provision in Germany: Evidence from a Social Experiment," ZEW Discussion Papers 08-114, ZEW - Leibniz Centre for European Economic Research.

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    More about this item

    Keywords

    consumer-directed long-term care; social experiment; personal budget; evaluation; Germany;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments

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