Abstract
We use data from the Survey of Health, Ageing and Retirement in Europe to examine the hours of home care received by the elderly. The existing empirical literature has mostly examined informal home care from children and formal home care. We identify two additional informal home care providers, namely, relatives (other than children) and friends (including neighbors) who provide about 30 % of the hours of informal home care. Our main new empirical finding is that single elderly persons who can rely less on children—and in particular daughters—for their home care receive not only more formal care but also more care from friends and neighbors. These findings suggest that policymakers need to take into account not only home care provision from children but also home care provision from friends and neighbors to obtain accurate projections concerning the increasing costs of formal care programs due to an aging population.
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Notes
SHARE release 2.5.0. SHARE data collection in 2004–2007 was primarily funded by the European Commission through its 5th and 6th framework programmes (project numbers QLK6-CT-2001- 00360; RII-CT- 2006-062193; CIT5-CT-2005-028857). Additional funding by the US National Institute on Aging (grant numbers U01 AG09740-13S2; P01 AG005842; P01 AG08291; P30 AG12815; Y1-AG-4553-01; OGHA 04-064; R21 AG025169), as well as by various national sources, is gratefully acknowledged (see http://www.share-project.org for a full list of funding institutions).
Information on formal home care is missing for Greece and Switzerland and these two countries are therefore excluded from the analysis (about 14 % of the total sample).
For single elderly we carried out our empirical analysis separately for North (Sweden, Denmark, The Netherlands), Central (Austria, Germany, Belgium, France) and South (Italy, Spain) European countries. Although a separate analysis yields fewer statistically significant results, our main conclusions are by and large the same.
See Byrne et al. (2009) for a structural model of family decisions about the provision of informal, versus formal, care for the elderly.
The Grossman model of health capital has been extended in several ways and not only to include long-term care as an input in the health function. As an example, Anderson and Grossman (2009) clarify the relation between health and human capital accumulation processes, which is crucial for a proper life cycle analysis of household economic decisions.
An alternative is to model the hours of home care from each provider unconditional on receiving home care (see, e.g., Pezzin et al. 2009). Our main conclusions are not affected if we employ this alternative model.
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Acknowledgments
We wish to thank Rob Alessie, Eric Bonsang, Bas van Groezen and the seminar participants at the International SHARE User Conference in Mainz, Germany, Utrecht School of Economics, University of Bologna, RWI Essen, Netspar annual workshop, and the London School of Economics (Workshop on the Future of Family Support for Older People and International Conference on Evidence-based Policy in Long Term Care) for valuable comments and discussion. Financial support has also been provided by Stichting Instituut GAK through the Network for Studies on Pensions, Aging and Retirement (NETSPAR), the Tjalling Koopmans Institute (Utrecht University), the Short Stay Ph.D. Fellowship of Utrecht University and Farmafactoring Foundation.
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Kalwij, A., Pasini, G. & Wu, M. Home care for the elderly: the role of relatives, friends and neighbors. Rev Econ Household 12, 379–404 (2014). https://doi.org/10.1007/s11150-012-9159-4
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DOI: https://doi.org/10.1007/s11150-012-9159-4