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Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data
The Netherlands is one of the few countries that offer generous universal public coverage of long‐term care (LTC). Does this ensure that the Dutch elderly with similar care needs receive similar LTC, irrespective of their income? In contrast with previous studies of inequity in care use that relied...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078855/ https://www.ncbi.nlm.nih.gov/pubmed/31958885 http://dx.doi.org/10.1002/hec.3994 |
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author | Tenand, Marianne Bakx, Pieter van Doorslaer, Eddy |
author_facet | Tenand, Marianne Bakx, Pieter van Doorslaer, Eddy |
author_sort | Tenand, Marianne |
collection | PubMed |
description | The Netherlands is one of the few countries that offer generous universal public coverage of long‐term care (LTC). Does this ensure that the Dutch elderly with similar care needs receive similar LTC, irrespective of their income? In contrast with previous studies of inequity in care use that relied on a statistically derived variable of needs, our paper exploits a readily available, administrative measure of LTC needs stemming from the eligibility assessment organized by the Dutch LTC assessment agency. Using exhaustive administrative register data on 616,934 individuals aged 60 and older eligible for public LTC, we find a substantial pro‐poor concentration of LTC use that is only partially explained by poorer individuals' greater needs. Among those eligible for institutional care, higher‐income individuals are more likely to use—less costly—home care. This pattern may be explained by differences in preferences, but also by their higher copayments for nursing homes and by greater feasibility of home‐based LTC arrangements for richer elderly. At face value, our findings suggest that the Dutch LTC insurance “overshoots” its target to ensure that LTC is accessible to poorer elderly. Yet, the implications depend on the origins of the difference and one's normative stance. |
format | Online Article Text |
id | pubmed-7078855 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-70788552020-03-19 Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data Tenand, Marianne Bakx, Pieter van Doorslaer, Eddy Health Econ Research Articles The Netherlands is one of the few countries that offer generous universal public coverage of long‐term care (LTC). Does this ensure that the Dutch elderly with similar care needs receive similar LTC, irrespective of their income? In contrast with previous studies of inequity in care use that relied on a statistically derived variable of needs, our paper exploits a readily available, administrative measure of LTC needs stemming from the eligibility assessment organized by the Dutch LTC assessment agency. Using exhaustive administrative register data on 616,934 individuals aged 60 and older eligible for public LTC, we find a substantial pro‐poor concentration of LTC use that is only partially explained by poorer individuals' greater needs. Among those eligible for institutional care, higher‐income individuals are more likely to use—less costly—home care. This pattern may be explained by differences in preferences, but also by their higher copayments for nursing homes and by greater feasibility of home‐based LTC arrangements for richer elderly. At face value, our findings suggest that the Dutch LTC insurance “overshoots” its target to ensure that LTC is accessible to poorer elderly. Yet, the implications depend on the origins of the difference and one's normative stance. John Wiley and Sons Inc. 2020-01-20 2020-04 /pmc/articles/PMC7078855/ /pubmed/31958885 http://dx.doi.org/10.1002/hec.3994 Text en © 2020 The Authors. Health Economics published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Tenand, Marianne Bakx, Pieter van Doorslaer, Eddy Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data |
title | Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data |
title_full | Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data |
title_fullStr | Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data |
title_full_unstemmed | Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data |
title_short | Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data |
title_sort | equal long‐term care for equal needs with universal and comprehensive coverage? an assessment using dutch administrative data |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078855/ https://www.ncbi.nlm.nih.gov/pubmed/31958885 http://dx.doi.org/10.1002/hec.3994 |
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