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Unravelling Hidden Inequities in a Universal Public Long-Term Care System

Pilar Garcia-Gomez (), Helena M Hernandez-Pizarro (), Guillem Lopez-Casasnovas () and Joaquim Vidiella-Martin ()
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Helena M Hernandez-Pizarro: Universitat Pompeu Fabra
Guillem Lopez-Casasnovas: Universitat Pompeu Fabra
Joaquim Vidiella-Martin: Erasmus University Rotterdam

No 19-011/V, Tinbergen Institute Discussion Papers from Tinbergen Institute

Abstract: We investigate whether publicly subsidized long-term care (LTC) is allocated according to needs, independently from income, using administrative data from all applicants for public LTC in Catalonia, from 2011 to 2014. We measure the level of horizontal inequity in subsidies to compensate informal care costs, formal home care, and institutional care using objective detailed information on needs. Our findings suggest that the system is inequitable; cash transfers are distributed among the financially better-off, while the use of nursing homes is concentrated among the worse-off. Additionally, we assess the inequity in the form of provision (voucher versus in- kind) and its implications for the equity in the time to access. Our results show that while in-kind provision is concentrated among the worse-off, the better-off are more likely to receive a voucher to (partly) subsidize LTC expenses. However, this duality does not imply inequity in the time to access a nursing home.

Keywords: long-term care; equity; public provision; voucher; in-kind (search for similar items in EconPapers)
JEL-codes: I14 I38 J14 (search for similar items in EconPapers)
New Economics Papers: this item is included in nep-age, nep-eur and nep-hea
Date: 2019-02-05
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