The Hidden Value of Adult Informal Care in Europe

IF 2.4 3区 医学 Q2 ECONOMICS Health economics Pub Date : 2025-01-29 DOI:10.1002/hec.4928
Joan Costa-Font, Cristina Vilaplana-Prieto
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Abstract

The hidden value of adult informal care (IC) refers to the unaccounted value of informal care in overall costs of long-term care (LTC) estimates. This paper estimates the net value of adult IC in Europe, drawing on a well-being-based methodology. We use an instrumental variable strategy and a longitudinal and cross-country dataset to estimate the causal effect of the extensive and intensive margin of caregiving on subjective well-being. We estimate the so-called compensating surplus (CS), namely the income equivalent transfer, to compensate for the net disutility of caregiving. We show that IC reduces average subjective well-being by about 1% compared to the mean (6% among co-residential caregivers). Relative to a country's Gross Domestic Product (GDP), the value of IC ranges between 4.2% in France and 0.85% in Germany. Such relative value declines as the country's share of formal LTC spending increases. These results call for a reconsideration of the existing classifications of LTC regimes. We estimate that the average CS per hour for IC is 9.55€, with a range from 22€ per hour in Switzerland to 5€ per hour in Spain. Additionally, we estimate that the long-term CS (estimated using an individual’s permanent income) tends to be lower than short-term CS (estimated using an individual’s current income).

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欧洲成人非正式护理的潜在价值。
成人非正式护理(IC)的隐藏价值是指在长期护理总成本(LTC)估计中未计算的非正式护理价值。本文估计了欧洲成人IC的净值,借鉴了基于福祉的方法。我们使用工具变量策略和纵向和跨国数据集来估计广泛和密集的照顾边际对主观幸福感的因果影响。我们估计所谓的补偿盈余(CS),即收入等效转移,以补偿照顾的净负效用。我们表明,与平均水平相比,IC降低了平均主观幸福感约1%(在共同居住的照顾者中为6%)。相对于一个国家的国内生产总值(GDP),集成电路的价值在法国的4.2%和德国的0.85%之间。这种相对价值随着国家在正式LTC支出中所占份额的增加而下降。这些结果要求重新考虑现有的LTC制度分类。我们估计IC的平均每小时CS为9.55欧元,从瑞士的22欧元到西班牙的5欧元不等。此外,我们估计长期CS(使用个人永久收入估算)往往低于短期CS(使用个人当前收入估算)。
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来源期刊
Health economics
Health economics 医学-卫生保健
CiteScore
3.60
自引率
4.80%
发文量
177
审稿时长
4-8 weeks
期刊介绍: This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems. Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses. Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.
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