Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T13:34:03.678Z Has data issue: false hasContentIssue false
  • English
  • Français

Does availability of informal care within the household impact hospitalisation?

Published online by Cambridge University Press:  08 April 2013

France M. Weaver  and
Bryce A. Weaver
France M. Weaver*
Affiliation:
SSPH+ Assistant Professor, Department of Economics, University of Geneva, Geneva, Switzerland
Bryce A. Weaver
Affiliation:
Department of Mathematics, Indiana University, Bloomington, IN, USA
*
*Correspondence to: France M. Weaver, SSPH+ Assistant Professor, Department of Economics, University of Geneva, Bd du Pont d'Arve 40, 1211 Geneva 4, Switzerland. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This study assesses the effect of having informal support available at home on inpatient care use in Switzerland. The main contributions are to consider the availability of care regardless of its source, measured by multiple-adult living arrangements, and to examine this effect by type of inpatient care and source of potential support. A two-part model with region and time fixed effects is estimated to determine the impact of informal care availability on the likelihood of hospitalisation and length of stay, conditional on hospitalisation. The analysis is conducted on a sample of individuals aged 18+ from four waves of the Swiss Household Panel survey (2004–2007). Overall, availability of informal care has no impact on the likelihood of hospitalisation but does significantly reduce length of stay by 1.9 days. Available support has no effect on the shortest stays (up to 10 days), but has a significant impact on acute care stays up to 30 days and longer stays. Additionally, the effect does not significantly vary whether the source of informal support is a spouse only, a spouse and other adults, or other adults only. These results indicate that social changes leading to an expansion in the proportion of one-person households may increase future inpatient care use.

Type
Articles
Information
Health Economics, Policy and Law , Volume 9 , Issue 1 , January 2014 , pp. 71 - 93
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andersen, R. M. (1968), Behavioral Model of Families’ Use of Health Services, Research Series No. 25. Chicago, IL: Center for Health Administration Studies, University of Chicago.Google Scholar
Andersen, R. M. (1995), ‘Revisiting the behavioral model and access to medical care: does it matter?’, Journal of Health and Social Behaviour, 36(1): 1–10.CrossRefGoogle ScholarPubMed
Becker, G. (1981), Treatise on the Family, Cambridge MA: Harvard University Press.Google Scholar
Bolin, K., Lindgren, B.Lundborg, P. (2008), ‘Informal and formal care among single-living elderly in Europe’, Health Economics, 17(3): 393–409.Google Scholar
Bonsang, E. (2009), ‘Does informal care from children to their elderly parents substitute for formal care in Europe?’, Journal of Health Economics, 28(1): 143–154.Google Scholar
Börsch-Supan, A., McFadden, D.Schnabel, R. (1996), ‘Living Arrangements: Health and Wealth Effects’, in D. Wise (ed.), Advances in the Economics of Aging, Chicago: University of Chicago Press, 193–212.Google Scholar
Byrne, D., Goeree, M. S., Hiedermann, B.Stern, S. (2009), ‘Formal home health care, informal care, and family decision making’, International Economic Review, 50(4): 1205–1242.Google Scholar
Charles, K. K.Sevak, P. (2005), ‘Can family caregiving substitute for nursing home care?’, Journal of Health Economics, 24(6): 1174–1190.Google Scholar
Dormont, B., Goeffard, P. Y.Lamiraud, K. (2009), ‘The influence of supplemental health insurance on switching behavior: evidence from Swiss data’, Health Economics, 18(11): 1339–1356.Google Scholar
Dostie, B.Leger, P. T. (2005), ‘The living arrangement dynamics of sick, elderly individuals’, The Journal of Human Resources, 40: 989–1014.CrossRefGoogle Scholar
Duan, N., Manning, W. G., Morris, C. N.Newhouse, J. P. (1984), ‘Choosing between the sample-selection and multi-part model’, Journal of Business and Economic Statistics, 2(3): 283–289.Google Scholar
Engers, M.Stern, S. (2002), ‘Long-term care and family bargaining’, International Economic Review, 43: 1–44.Google Scholar
Federal Office of Private Insurance (FOPI) (2010), ‘Facts and Figures’, http://www.finma.ch/archiv/bpv/e/themen/00503/00607/index.html?lang=en [April 2010].Google Scholar
Federal Statistical Office (FSO) (2010a), Population résidante permanente par sexe et âge selon le scénario A-00-2005/09 de 2009 à 2050, http://www.bfs.admin.ch/bfs/portal/fr/index/themen/01/03/blank/key/ind_erw.html [March 2010].Google Scholar
FSO (2010b), Ménages privés en Suisse par taille du ménage selon le scénario AM-00-2005 de 2005 à 2030, http://www.bfs.admin.ch/bfs/portal/fr/index/themen/01/03/blank/key_hhsz.html [March 2010].Google Scholar
FSO (2011), ‘Swiss Health Survey, 2007’, http://www.bfs.admin.ch/bfs/portal/en/index/themen/14/22/publ.html? [November 2011].Google Scholar
Freedman, V. A. (1996), ‘Family structure and the risk of nursing home admission’, Journal of Gerontology: Social Sciences, 51B: S61–S69.Google Scholar
Fux, B., Sauvain-Dugerdil, C., Stutz, H., Strub, S., Leuba, A., Tritten, C., Krummenacher, J. (Hrsg.) (2006), Pflegen, betreuen und bezahlen. Familien in späteren Lebensphasen, Bern: Bundesamt für Sozialversicherung.Google Scholar
Gaugler, J. E., Duval, S., Anderson, K. A.Kane, R. L. (2007), ‘Predicting nursing home admission in the US: a meta-analysis’, BMC Geriatrics, 7–13: 1–14.Google Scholar
Giovannetti, E. R.Wolff, J. L. (2010), ‘Cross-survey differences in national estimates of numbers of caregivers of disabled older adults’, Milbank Quarterly, 88(3): 310–349.Google Scholar
Greene, V. L. (1983), ‘Substitution between formally and informally provided care for the impaired elderly in the community’, Medical Care, 21(6): 609–619.CrossRefGoogle ScholarPubMed
Hanley, R. J., Wiener, J. M.Harris, K. M. (1991), ‘Will paid home care erode informal support?’, Journal of Health Politics, Policy and Law, 16(3): 507–521.CrossRefGoogle ScholarPubMed
Hays, J. C., Pieper, C. F.Purser, J. L. (2003), ‘Competing risk of household expansion or institutionalization in later life’, Journal of Gerontology Social Sciences, 58: S11–S20.Google Scholar
Hoerger, T. J., Picone, A.Sloan, F. A. (1996), ‘Public subsidies, private provision of care and living arrangement of the elderly’, The Review of Economics and Statistics, 78(3): 428–440.Google Scholar
Höpflinger, F.Hugentobler, V. (2005), Familiale, ambulante und stationäre Pflege im Alter. Perspektiven für die Schweiz, Bern: Verlag Hans Huber.Google Scholar
Jaccard-Ruedin, H., Weber, A., Pellegrini, S.Jeanrenaud, C. (2006), Comparaison intercantonale du recours aux soins de longue durée en Suisse, Document de travail 17. Neuchâtel: Obsan.Google Scholar
Jette, A. M., Tennstedt, S.Crawford, S. (1995), ‘How does formal and informal community care affect nursing home use’, Journal of Gerontology Social Sciences, 50(1): S4–S12.Google Scholar
Kasper, J. D., Pezzin, L. E.Bradford Rice, J. (2010), ‘Stability and changes in living arrangements: relationship to nursing home admission and timing of placement’, Journal of Gerontology Social Sciences, 65B(6): 783–791.Google Scholar
Lillard, L. A.Panis, C. W. A. (1996), ‘Marital status and mortality: the role of health’, Demography, 33(3): 313–327.Google Scholar
Lo Sasso, A. T.Johnson, R. W. (2002), ‘Does informal care from adult children reduce nursing home admissions for the elderly?’, Inquiry, 39: 279–297.Google Scholar
Lui, K., McBride, T.Coughlin, T. (1994), ‘Risk of entering nursing homes for long versus short stays’, Medical Care, 32: 315–327.Google Scholar
MacKinnon, J., White, H.Davidson, R. (1983), ‘Tests for model specification in the presence of alternative hypotheses: some further results’, Journal of Econometrics, 21: 53–70.CrossRefGoogle Scholar
Manning, W. G. (1998), ‘The logged dependent variable, heteroscedasticity, and the retransformation problem’, Journal of Health Economics, 17: 283–295.Google Scholar
Miller, E. A.Weissert, W. G. (2000), ‘Predicting elderly people's risk for nursing home placement, hospitalization, functional impairment, and mortality: a synthesis’, Medical Care Research and Review, 57(3): 259–297.CrossRefGoogle ScholarPubMed
Morger, M.Rossel, R. (2009), Coût et financement du système de santé. Résultats détaillés 2007 et évolution récente, Neuchâtel: Federal Statistical Office.Google Scholar
Newman, S. J., Struyk, R., Wright, P.Rice, M. (1990), ‘Overwhelming odds: caregiving and the risk of institutionalization’, Journal of Gerontology Social Sciences, 45: S173–S183.Google Scholar
Noelker, L. S.Bass, D. M. (1989), ‘Home care for elderly persons: linkages between formal and informal caregivers’, Journal of Gerontology Social Sciences, 44(2): S63–S70.Google Scholar
Norton, E. C. (2000), ‘Long-term care’, in Culyer A. J. and Newhouse, J. P. (eds), Handbook of Health economics, New York, NY: Elsevier Science B. V.Google Scholar
OECD (2005), Long-Term Care for Older People, Paris: OECD editions.Google Scholar
OECD (2011), Statistical portal, Glossary of statistical terms, http://stats.oecd.org/glossary/detail.asp?ID=5 [November 2010].Google Scholar
Pezzin, L. E., Pollak, R. A.Schone, B. S. (2007), ‘Efficiency in family bargaining: living arrangement and caregiving decisions of adult children and disabled elderly parents’, CESifo Economic Studies, 53(1): 69–96.Google Scholar
Schellhorn, M. (2001), ‘The effect of variable health insurance deductible on the demand for physician visits’, Health Economics, 10(5): 441–456.Google Scholar
Schön-Bühlmann, J. (2008), Le travail bénévole en Suisse, Neuchâtel: Federal Statistical Office.Google Scholar
Swiss Health Observatory (Obsan) (2010a), Taux d'hospitalisation dans les hôpitaux de soins généraux et cliniques spécialisées, sauf les cliniques de psychiatrie, de réadaptation et de gériatrie, pour 1000 habitants, http://www.obsandaten.ch/indikatoren/6_1_1/2005/f/611.pdf [March 2010].Google Scholar
Obsan (2010b), Densité des lits d'hospitalisation par 1000 habitants dans les hôpitaux de soins généraux et cliniques spécialisées, sauf les cliniques de psychiatrie, de réadaptation et de gériatrie, pour 1000 habitants, http://www.obsandaten.ch/indikatoren/5_2_1/2005/f/521.pdf [March 2010].Google Scholar
Stern, S. (1995), ‘Estimating family long-term care decisions in the presence of endogenous child characteristics’, Journal of Human Resources, 30: 551–580.Google Scholar
Stuckelberger, A.Wanner, P. (2005), Services for supporting family carers of elderly people in Europe: characteristics, coverage and usage. EUROFAMCARE. National background report for Switzerland, Supported by the European Union, contract QLK6-CT-2002-02647. Geneva: University of Geneva.Google Scholar
Van den Berg, B.Spauwen, P. (2006), ‘Measuring of informal care: an empirical study into the valid measurement of time spent on informal care giving’, Health Economics, 15: 447–460.Google Scholar
Van Houtven, C. H.Norton, E. C. (2004), ‘Informal care and health care use of older adults’, Journal of Health Economics, 23(6): 1159–1180.CrossRefGoogle ScholarPubMed
Van Houtven, C. H.Norton, E. C. (2008), ‘Informal care and Medicare expenditures: testing for heterogeneous treatment effects’, Journal of Health Economics, 27(1): 134–156.Google Scholar
Weaver, F., Stearns, S. C., Norton, E. C.Spector, W. (2009), ‘Proximity to death and participation in the long-term care market’, Health Economics, 18(8): 867–883.Google Scholar
Wood, R. G., Goesling, B.Avellar, S. (2007), The effects of marriage on health: a synthesis of recent research evidence, Prepared for the Department of Health and Human Services, contract number 233-02-0096, Mathematica Policy Research Inc, http://aspe.hhs.gov/hsp/of/marriageonhealth.Google Scholar
Wooldridge, Y. H. (2000), Econometric Analysis of Cross Section and Panel Data, 1st edition, Cambridge, MA: MIT Press.Google Scholar