Long term care and migration

组织长期护理（LTC）是未来几年社会和政治上最紧迫的挑战之一。在经合组织国家中，到2050年，80岁及以上人口的比例将从平均近5%增加到近10%（经合组织，2020年）。这种快速老化将对长期护理的需求和供应产生重大影响。长期护理服务的提供问题对德国尤为重要，在经合组织国家中，到2050年，80岁以上老人最多的国家排名第三。与此同时，在德国联邦就业局编制的年度“瓶颈”职业名单中，老年护理护士在过去九年中每次都被列入其中。与其他发达国家政府一样，德国希望移民在满足日益增长的护理需求方面发挥重要作用。事实上，外国LTC工人在德国的比例从2014年的8%增加到2019年的14%。通过这项研究提案，我们的目标是提供因果证据，说明移民护理人员的流入如何影响长期护理的提供。此外，除了劳动力市场的影响，我们实证研究，如果流动护理人员的流入影响的质量和价格的长期护理服务提供和护理对象的健康结果。 具体而言，研究计划包括四个不同的研究项目，所有这些研究项目都将考察长期培训移民工人供应量大幅增加对一系列多维结果的因果影响：（i）劳动力市场影响，包括地区层面上的本地工资，就业和正式长期培训空缺;（ii）个人层面的本地职业轨迹和工资演变;（iii）正规护理服务的可用性、质量和价格;（iv）老年人的健康结果。这一大规模的移民流入是由2011年和2014年德国劳动力市场向东欧国家开放引起的，其特点是强烈的区域异质性，这是我们识别战略的基础。

Organizing long-term care (LTC) is one of the most pressing challenges for the coming years, both societally and politically. Across OECD countries, the proportion of individuals aged 80 and above will increase from an average of nearly five to almost ten percent of the population by 2050 (OECD, 2020). This rapid aging will have sizable implications for the demand and provision of LTC. The issue of LTC provision is particularly relevant for Germany which, in the ranking of OECD countries with most above-eighty-year-olds by 2050, takes the third place. At the same time, in the yearly list of ‘bottleneck’ occupations complied by the German Federal Employment Agency, the elderly care nurse has been included every time for the last nine years. Like governments in other developed countries, Germany looks to migration to play a large role in meeting the ever-growing demand for care. Indeed, the share of foreign LTC workers in Germany increased from 8% in 2014 to 14% in 2019. With this research proposal, we aim to provide causal evidence on how the inflow of migrant care workers affects long-term care provision. Moreover, besides the labor market implications, we empirically examine if the inflow of migrant care workers affects the quality and the prices of LTC provision and the health outcomes of the care recipients. Specifically, the research proposal includes four different research projects, of all which examine the causal implications of the sizable increase in the supply of migrant LTC workers on a multidimensional set of outcomes: (i) labor market effects including native wages, employment and vacancy in formal LTC on the regional level; (ii) native career trajectories and wage evolution on the individual level, (iii) the availability, quality, and price of formal care services; and (iv) the health outcomes of elderly individuals. This large inflow of migrants was induced by the 2011 and 2014 German labor market openings towards the Eastern European countries and is characterized by strong regional heterogeneity, which is the basis for our identification strategies.