Abstract
Informal care may substitute for formal long‐term care that is often publicly funded or subsidized. The costs of informal caregiving are borne by the caregiver and may consist of worse health outcomes and, if the caregiver has not retired, worse labor market outcomes. We estimate the impact of providing informal care to one's partner on the caregiver's health using data from the Survey of Health, Ageing, and Retirement in Europe. We use statistical matching to deal with selection bias and endogeneity. We find that in the short run caregiving has a substantial effect on the health of caregivers and, for female caregivers, on their health care use. These effects should be taken into account when comparing the costs and benefits of formal and informal care provision. The health effects may, however, be short‐lived, as we do not find any evidence that they persist after 4 or 7 years.
Highlights
Informal caregiving to frail elderly by family or friends is often regarded as an important way to sustainably meet the rising demand for long‐term care, in particular because its direct costs appear much lower than the costs of formal care provided by professionals: Informal caregivers generally do not receive monetary compensation (OECD, 2011)
We study the impact of providing informal care on the health and health care use of caregiving spouses using data from the Survey on Health, Ageing and Retirement in Europe (SHARE)
We study the impact of caregiving on four outcome measures: (a) whether the respondent uses prescription drugs, (b) the number of doctor visits in the past 12 months, (c) depression as measured by the EURO‐D scale (Prince et al, 1999) ranging from 0 to 12,13 and (d) self‐perceived health (SPH) on a 5‐point scale
Summary
Informal caregiving to frail elderly by family or friends is often regarded as an important way to sustainably meet the rising demand for long‐term care, in particular because its direct costs appear much lower than the costs of formal care provided by professionals: Informal caregivers generally do not receive monetary compensation (OECD, 2011). We study the impact of providing informal care on the health and health care use of caregiving spouses using data from the Survey on Health, Ageing and Retirement in Europe (SHARE). Using data from the US Health and Retirement Survey on the characteristics of siblings and the death of the mother as instrumental variables, Coe and Van Houtven (2009) find significant negative effects on mental health and self‐reported health (married respondents) and heart conditions (single men), both immediately and a few years later (depressive symptoms in married women only) They find a 15% increase in the mean score of their depression measure due to the onset of caregiving. The respondent's ability may be proxied by age; gender; whether he provided informal care at wave 1 and his health status; and the willingness to provide informal care by employment status, education level, income, wealth, and proxies for personality
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