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Left behind: Long-term care gaps and healthcare access in later life

Di Novi; C.;

Health, Econometrics and Data Group (HEDG) Working Papers from HEDG, c/o Department of Economics, University of York

Abstract: Population ageing and declining availability of informal care are increasing unmet long- term care (LTC) needs across Europe. While previous studies document associations between unmet LTC needs and adverse health outcomes, evidence on their relationship with healthcare access remains limited. This paper examines the relationship between unmet LTC needs and healthcare access among older Europeans, conceptualising LTC as an enabling input that supports daily activities, instrumental tasks, and mobility. Using data from Waves 8 and 9 of the Survey of Health, Ageing and Retirement in Europe (SHARE), combined with both waves of the SHARE Corona Survey, I focus on individuals aged 65 and over with functional limitations. To address potential endogeneity, I use an instrumental-variable strategy based on variation in informal care availability. The IV estimates suggest that unmet LTC needs are associated with substantially lower use of healthcare services, consistent with potential spill over effects from LTC provision into the healthcare system. These findings suggest that strengthening LTC services may improve equity in healthcare access and help prevent delayed treatment and avoidable health deterioration that ultimately increases pressure on healthcare systems.

Keywords: long-term care (LTC); disability; unmet LTC needs; healthcare access (search for similar items in EconPapers)
JEL-codes: C26 I10 I18 (search for similar items in EconPapers)
Date: 2026-07
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