Abstract
ABSTRACTDespite increasing attention to long-term care (LTC) and related challenges in the Estonian social policy agenda, the distributional fairness of LTC services in the country has received very limited attention. Using SHARE data, we address informal and formal home care services and identify the socio-economic factors that drive or hinder their use among the Estonian elderly. The relationship between informal and formal home care utilization is estimated applying the new approach to instrumental variable method proposed by Lewbel [2012. Using heteroscedasticity to identify and estimate mismeasured and endogenous regressor models. Journal of Business and Economic Statistics, 30(1), 67–80]. We find that it is important to distinguish among informal care provided by household members, other relatives and non-relatives because the same socio-economic factors might differentially affect the propensity to use these kinds of care. The estimation results indicate that informal care provided by non-relatives complements formal home care. LTC policy in Estonia ensures the absence of tangible financial, ethnic and urban/rural barriers to the use of formal home care.
Highlights
Rapid population ageing is expected to pose various challenges for long-term care (LTC) systems all over Europe in the near future
This approach raises some important points on the association between informal and formal home care use in Estonia: our results suggest that informal care provided by non-relatives complements formal home care, while the effect of informal care provided by relatives, living either with the elderly person or separately, on the utilization of formal home care is not statistically significant
Given that the Estonian LTC system is centred on informal care and public spending on social LTC as well as the associated coverage indicators are low, analysing the distributional fairness of LTC services is important in Estonia
Summary
Rapid population ageing is expected to pose various challenges for long-term care (LTC) systems all over Europe in the near future. The approach adopted in this paper sheds light on some peculiarities of the determinants of informal LTC use, proposing that the same factors may affect the propensity to use various kinds of informal care in different directions This approach raises some important points on the association between informal and formal home care use in Estonia: our results suggest that informal care provided by non-relatives complements formal home care, while the effect of informal care provided by relatives, living either with the elderly person or separately, on the utilization of formal home care is not statistically significant.
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