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LTC的需求和供应产生重大影响。长期养老保险规定的问题与德国尤其相关。在经合组织国家中，到2050年，德国的80岁以上老人数量最多，排在第三位。与此同时，在德国联邦就业局（German Federal Employment Agency）编制的年度“瓶颈”职业清单中，在过去九年中，老年人护理护士每次都被列入其中。与其他发达国家的政府一样，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，德国外籍LTC员工的比例从2014年的8%上升到2019年的14%。通过这项研究，我们旨在提供关于流动护理工作者流入如何影响长期护理提供的因果证据。此外，除了劳动力市场的影响外，我们还实证研究了流动护理工作者的流入是否影响长期护理服务的质量和价格以及护理接受者的健康结果。具体而言，该研究提案包括四个不同的研究项目，其中所有研究项目都研究了移民LTC工人供应大幅增加对多维结果集的因果影响：(i)劳动力市场影响，包括区域层面上正式LTC的本地工资、就业和空缺；（ii）本地职业轨迹和个人水平上的工资演变；（iii）正规护理服务的可得性、质量和价格；（四）老年人的健康状况。2011年和2014年德国劳动力市场向东欧国家开放导致了大量移民流入，并具有强烈的区域异质性，这是我们识别策略的基础。

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.