Catastrophic long-term care expenditure: associated socio-demographic and economic factors

Raúl Pozo-Rubio (), Román Mínguez-Salido (), Isabel Pardo-García () and Francisco Escribano-Sotos ()
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Raúl Pozo-Rubio: University of Castilla-La Mancha
Román Mínguez-Salido: University of Castilla-La Mancha
Isabel Pardo-García: University of Castilla-La Mancha
Francisco Escribano-Sotos: University of Castilla-La Mancha
Authors registered in the RePEc Author Service: Francisco Escribano Sotos ()

The European Journal of Health Economics, 2019, vol. 20, issue 5, No 6, 701 pages

Abstract: Abstract Objective An increasing number of persons across the world require long-term care (LTC). In Spain, access to LTC involves individuals incurring out-of-pocket (OOP) expenditure. There is a large body of literature on the incidence of catastrophic OOP payments in access and participation in health systems, but not in the field of LTC nor the determinants of these expenses. Our aim was to analyse the socio-demographic and economic factors associated with different levels of catastrophic LTC expenditure in the form of private out-of-pocket payments among dependent persons in Spain. Materials and methods The study used the Spanish Disability and Dependency Survey (SDDS) conducted by the Spanish National Statistics Institute to obtain the socioeconomic, demographic and health profiles. The households were classified into those below the poverty threshold and those above the threshold of catastrophe, using measures of impoverishment and catastrophe. We estimated two logistic regression models, one binary (impoverishment) and one ordinal (catastrophe). Results The results show that OOP expenditure on LTC increases the probability of impoverishment by 18.90%. The factors associated with higher probability of experiencing catastrophe were age, being single, widowed or separated, lower levels of household income and education, higher level of dependence and living in an autonomous community with lower per capita income. Conclusions These findings highlight the need to include exemptions or insurance in the design of LTC policies to protect dependent persons from the risk of financial burden.

Keywords: Catastrophic; Long-term care; Out-of pocket; Dependence (search for similar items in EconPapers)
JEL-codes: G38 I38 J14 (search for similar items in EconPapers)
Date: 2019
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Citations: View citations in EconPapers (3)

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DOI: 10.1007/s10198-019-01031-8

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