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A Macro Prediction of the Use of Care Provisions in the Netherlands

A Macro Prediction of the Use of Care Provisions in the Netherlands. Jedid-Jah Jonker, Ingrid Ooms, Isolde Woittiez, Social and Cultural Planning Office Discussant: Paul McNamee, HERU, University of Aberdeen, UK. Aims.

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A Macro Prediction of the Use of Care Provisions in the Netherlands

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  1. A Macro Prediction of the Use of Care Provisions in the Netherlands Jedid-Jah Jonker, Ingrid Ooms, Isolde Woittiez, Social and Cultural Planning Office Discussant: Paul McNamee, HERU, University of Aberdeen, UK

  2. Aims • To examine the determinants of the use of different forms of long-term care (LTC) • To determine the extent to which different forms of LTC are substitutes for one another • To produce forecasts of different forms of LTC use for 2005-2020

  3. Methods • 2 different surveys of persons living at home and in institutions (n=9,455) • LTC classified into 8 categories • Health status (disease, limitations) • Socio-demographic and economic

  4. Modelling approach • Nested logit • Multinomial logit • Macro modelling using population data to forecast LTC use at a national level

  5. Results - I • Most variables behave in the expected way (e.g. limitation in daily tasks predictive of any LTC use and more resource intensive forms of LTC) • Few variables behave in an unexpected way • Some variables have little or no effect (e.g. diseases / limitations does not increase probability of privately paid care vs. informal care)

  6. Results - II • Nested logit and multinomial logit produce comparable results • People forecasted to use more LTC • Use of privately paid care rises the most amongst the different forms of LTC

  7. General comments • Interesting and novel – macro modelling from micro data • More information on LTC policy – to what extent is access to publicly funded care subject to income/asset tests? • Representativeness of sample? (persons living at home conducted amongst independently living persons?) • The modelling strategy – how robust for people with more than 1 form of LTC?

  8. Specific comments • The modelling strategy: - health assumed to be exogenous - tests for endogeneity? - test for the IIA assumption by dropping some variables? • OV bias? – informal care likely to be a substitute for other forms of LTC – use of probit/logit models to check? • “..surprising that disease/limitations do not affect choice between informal & private care” – but does it simply reveal they are substitutes?

  9. Other issues • When/where were the surveys conducted? (if recent, could you compare the forecast with the actual?) • How is the supply side handled? • Are different forms of LTC substitutes or not? • Interpretation of the macro results – why large rise in privately paid care? – is model being driven by age changes rather than other variables?

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