Who benefits from public financing of home-based long term care? Evidence from Medicaid

IF 4.8 1区 经济学 Q1 ECONOMICS Journal of Public Economics Pub Date : 2024-06-08 DOI:10.1016/j.jpubeco.2024.105151
Karen Shen
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Abstract

Due to population aging, the number of people needing long-term care is growing, and an increasing number of people are receiving this care at home, rather than in nursing homes. This trend has been driven in part by Medicaid, which has significantly increased public financing of formal home care over the past few decades. Using the 2000–2016 Health and Retirement Study and a difference-in-difference and triple-difference design, I investigate the effects of a Medicaid policy adopted in over half of states that increased formal home care utilization among low-income older adults by more than 50%. I show that the policy mainly replaces informal care, particularly from spouses and daughters. For daughters, there is an accompanying increase in labor supply: for approximately every three daughters whose parent receives formal home care due to the policy, one additional daughter works full-time.

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谁能从以家庭为基础的长期护理的公共资助中受益?医疗补助计划的证据
由于人口老龄化,需要长期护理的人数不断增加,越来越多的人在家中而不是在养老院接受护理。这一趋势的部分原因是医疗补助计划(Medicaid)的推动,该计划在过去几十年中大幅增加了对正规家庭护理的公共资助。利用 2000-2016 年健康与退休研究以及差分和三重差分设计,我调查了半数以上州采用的医疗补助政策的效果,该政策将低收入老年人的正规家庭护理利用率提高了 50%以上。我的研究表明,该政策主要取代了非正规护理,尤其是来自配偶和女儿的护理。对于女儿来说,劳动力供应也随之增加:大约每三个女儿的父母因该政策而接受正规家庭护理,就会增加一个女儿从事全职工作。
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来源期刊
CiteScore
14.10
自引率
2.00%
发文量
139
审稿时长
70 days
期刊介绍: The Journal of Public Economics aims to promote original scientific research in the field of public economics, focusing on the utilization of contemporary economic theory and quantitative analysis methodologies. It serves as a platform for the international scholarly community to engage in discussions on public policy matters.
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