Does informal care from children to their elderly parents substitute for formal care in Europe?
Does informal care from children to their elderly parents substitute for formal care in Europe?
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DOI：
10.1016/j.jhealeco.2008.09.002
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发表时间：
2009-01-01
影响因子：
3.5
通讯作者：
Bonsang, Eric
中科院分区：
文献类型：
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作者：
Bonsang, Eric
本文分析了欧洲成年子女的非正式照顾对老年人使用长期照顾的影响，以及父母残疾程度对这种关系的影响。我们关注两种最可能与非正式护理相互影响的正式家庭护理：有偿家政服务和护理服务。利用欧洲健康、老龄化和退休调查（SHARE）的最新欧洲数据，我们建立了一个由两部分组成的利用模型，分析了是否使用每种类型的正规护理的决定和老年人接受的正规护理的数量。工具变量估计用于控制存在于正式护理和非正式护理之间的潜在内生性。我们发现，在接受有偿家政服务的决定中，非正式护理具有内生性。估计结果表明，非正式护理替代了这种类型的正式家庭护理。然而，我们发现这种替代效应随着老年宠物儿子残疾水平的增加而趋于消失。最后，非正式护理是护理的弱补充，与残疾水平无关。这些结果突出了非正式护理对正式护理使用的异质性影响，并表明只要老年人的需求低且需要非熟练类型的护理，非正式护理就是长期护理的有效替代品。任何鼓励非正式护理以减少长期护理支出的政策都应考虑到这一点，以评估其有效性。(C) 2008 Elsevier B.V.版权所有
This paper analyzes the impact of informal care by adult Children on the use of long-term care among the elderly in Europe and the effect of the level of the parent's disability on this relationship. We focus on two types of formal home care that are the most likely to interact with informal care: paid domestic help and nursing care. Using recent European data emerging from the Survey on Health, Ageing and Retirement in Europe (SHARE), we build a two-part utilization model analyzing both the decision to use each type of formal care or not and the amount of formal care received by the elderly. Instrumental variables estimations are used to control for the potential endogeneity existing between formal and informal care. We find endogeneity of informal care in the decision to receive paid domestic help. Estimation results indicate that informal care substitutes for this type of formal home care. However, we find that this Substitution effect tends to disappear as the level of disability of the elderly pet-son increases. Finally, informal care is a weak complement to nursing care, independently of the level of disability, These results highlight the heterogeneous effects of informal care on formal care use and suggest that informal care is an effective substitute for long-term care as long as the needs of the elderly are low and require unskilled type of care. Any policy encouraging informal care to decrease long-term Care expenditures should take it into account to assess its effectiveness. (C) 2008 Elsevier B.V. All rights reserved.