[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/p/tin/wpaper/20180060.html
   My bibliography  Save this paper

Better off at home? Effects of a nursing home admission on costs, hospitalizations and survival

Author

Listed:
  • Pieter Bakx

    (Erasmus University Rotterdam)

  • Bram Wouterse

    (CPB)

  • Eddy (E.K.A.) van Doorslaer

    (Erasmus School of Economics Rotterdam)

  • Albert Wong

    (RIVM)

Abstract
Aging-in-place policies substitute home care for nursing home admissions (NHA). They appear to be a win-win by keeping public spending in check and being in line with personal preferences, but have hitherto not been evaluated. We study the impact of NHA eligibility using Dutch administrative data and exploiting variation between randomly assigned assessors in their tendency to grant admission. The impact on mortality is zero, but with considerable effect heterogeneity. Moreover, aging-in-place policies come at the cost of increased curative care, especially hospital admissions, and do not reduce total healthcare spending, suggesting they may not be a win-win after all.

Suggested Citation

  • Pieter Bakx & Bram Wouterse & Eddy (E.K.A.) van Doorslaer & Albert Wong, 2018. "Better off at home? Effects of a nursing home admission on costs, hospitalizations and survival," Tinbergen Institute Discussion Papers 18-060/V, Tinbergen Institute.
    • Handle: RePEc:tin:wpaper:20180060
    as

    Download full text from publisher

    File URL: https://papers.tinbergen.nl/18060.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Gordon B. Dahl & Andreas Ravndal Kostøl & Magne Mogstad, 2014. "Family Welfare Cultures," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 129(4), pages 1711-1752.
    2. Stephanie Riegg Cellini & Fernando Ferreira & Jesse Rothstein, 2010. "The Value of School Facility Investments: Evidence from a Dynamic Regression Discontinuity Design," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(1), pages 215-261.
    3. Arjen Hussem & Casper Ewijk & Harry Rele & Albert Wong, 2016. "The Ability to Pay for Long-Term Care in the Netherlands: A Life-cycle Perspective," De Economist, Springer, vol. 164(2), pages 209-234, June.
    4. David Autor & Nicole Maestas & Kathleen Mullen & Alexander Strand, 2011. "Does Delay Cause Decay? The Effect of Administrative Decision Time on the Labor Force Participation and Earnings of Disability Applicants," Working Papers wp258, University of Michigan, Michigan Retirement Research Center.
    5. A. Belloni & D. Chen & V. Chernozhukov & C. Hansen, 2012. "Sparse Models and Methods for Optimal Instruments With an Application to Eminent Domain," Econometrica, Econometric Society, vol. 80(6), pages 2369-2429, November.
    6. Joshua D. Angrist & Jörn-Steffen Pischke, 2009. "Mostly Harmless Econometrics: An Empiricist's Companion," Economics Books, Princeton University Press, edition 1, number 8769.
    7. Jing Guo & R. Tamara Konetzka & Willard G. Manning, 2015. "The Causal Effects of Home Care Use on Institutional Long‐Term Care Utilization and Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 4-17, March.
    8. Abbring, Jaap H & van den Berg, Gerard J, 2005. "Social experiments and intrumental variables with duration outcomes," Working Paper Series 2005:11, IFAU - Institute for Evaluation of Labour Market and Education Policy.
    9. Nicole Maestas & Kathleen J. Mullen & Alexander Strand, 2013. "Does Disability Insurance Receipt Discourage Work? Using Examiner Assignment to Estimate Causal Effects of SSDI Receipt," American Economic Review, American Economic Association, vol. 103(5), pages 1797-1829, August.
    10. Curtis Eberwein & John C. Ham & Robert J. Lalonde, 1997. "The Impact of Being Offered and Receiving Classroom Training on the Employment Histories of Disadvantaged Women: Evidence from Experimental Data," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 64(4), pages 655-682.
    11. David Autor & Nicole Maestas & Kathleen Mullen & Alexander Strand, 2011. "Does Delay Cause Decay? The Effect of Administrative Decision Time on the Labor Force Participation and Earnings of Disability Applicants," Working Papers wp258, University of Michigan, Michigan Retirement Research Center.
    12. Alexandre Belloni & Victor Chernozhukov & Christian Hansen, 2014. "High-Dimensional Methods and Inference on Structural and Treatment Effects," Journal of Economic Perspectives, American Economic Association, vol. 28(2), pages 29-50, Spring.
    13. Alders, Peter & Costa-Font, Joan & de Klerk, Mirjam & Frank, Richard, 2015. "What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands," Health Policy, Elsevier, vol. 119(6), pages 814-820.
    14. Eric French & Elaine Kelly & Pieter Bakx & Owen O'Donnell & Eddy Doorslaer, 2016. "Spending on Health Care in the Netherlands: Not Going So Dutch," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 593-625, September.
    15. Joseph J. Doyle Jr., 2007. "Child Protection and Child Outcomes: Measuring the Effects of Foster Care," American Economic Review, American Economic Association, vol. 97(5), pages 1583-1610, December.
    16. Nicole Maestas & Kathleen J. Mullen & Alexander Strand, 2013. "Does Disability Insurance Receipt Discourage Work? Using Examiner Assignment to Estimate Causal Effects of SSDI Receipt," American Economic Review, American Economic Association, vol. 103(5), pages 1797-1829, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Krabbe-Alkemade, Yvonne & Makai, Peter & Shestalova, Victoria & Voesenek, Tessa, 2020. "Containing or shifting? Health expenditure decomposition for the aging Dutch population after a major reform," Health Policy, Elsevier, vol. 124(3), pages 268-274.
    2. Maaike Diepstraten & Rudy Douven & Bram Wouterse, 2019. "Can your house keep you out of a nursing home?," CPB Discussion Paper 397, CPB Netherlands Bureau for Economic Policy Analysis.
    3. Marianne Tenand & Arjen Hussem & Pieter Bakx, 2020. "Promoting aging in place through flexible care options: recent developments from the Netherlands [Encourager le maintien à domicile des personnes âgées dépendantes par des modalités alternatives de," Working Papers hal-02985777, HAL.
    4. Marianne Tenand & Pieter Bakx & Eddy van Doorslaer, 2020. "Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 435-451, April.
    5. Marianne Tenand & Pieter Bakx & Eddy van Doorslaer, 2020. "Eligibility or use? Disentangling the sources of horizontal inequity in home care receipt in the Netherlands," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1161-1179, October.
    6. Maaike Diepstraten & Rudy Douven & Bram Wouterse, 2019. "Can your house keep you out of a nursing home?," CPB Discussion Paper 397.rdf, CPB Netherlands Bureau for Economic Policy Analysis.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    2. Manudeep Bhuller & Gordon B. Dahl & Katrine V. Løken & Magne Mogstad, 2020. "Incarceration, Recidivism, and Employment," Journal of Political Economy, University of Chicago Press, vol. 128(4), pages 1269-1324.
    3. Mathilde Godard & Pierre Koning & Maarten Lindeboom, 2024. "Application and Award Responses to Stricter Screening in Disability Insurance," Journal of Human Resources, University of Wisconsin Press, vol. 59(5), pages 1353-1386.
    4. Bhuller, Manudeep & Dahl, Gordon B & Løken, Katrine V. & Mogstad, Magne, 2018. "Incarceration Spillovers in Criminal and Family Networks," Discussion Paper Series in Economics 15/2018, Norwegian School of Economics, Department of Economics.
    5. Mathilde Godard & Maarten Lindeboom & Pierre Koning, 2018. "Targeting disability insurance applications with screening," Post-Print halshs-01960488, HAL.
    6. Park, Sujeong & Powell, David, 2021. "Is the rise in illicit opioids affecting labor supply and disability claiming rates?," Journal of Health Economics, Elsevier, vol. 76(C).
    7. Maclean, J. Catherine & Pichler, Stefan & Ziebarth, Nicolas R., 2020. "Mandated Sick Pay: Coverage, Utilization, and Welfare Effects," IZA Discussion Papers 13132, Institute of Labor Economics (IZA).
    8. Ivan A Canay & Magne Mogstad & Jack Mount, 2024. "On the Use of Outcome Tests for Detecting Bias in Decision Making," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 91(4), pages 2135-2167.
    9. Robert Collinson & John Eric Humphries & Nicholas Mader & Davin Reed & Daniel Tannenbaum & Winnie van Dijk, 2024. "Eviction and Poverty in American Cities," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 139(1), pages 57-120.
    10. Sylvain Chareyron & Naomie Mahmoudi, 2022. "The effects of disability benefits on the employment of low-skilled youth: Evidence from France," Erudite Working Paper 2022-09, Erudite.
    11. Silvia Garcia Mandico & Pilar (P.) Garcia-Gomez & Anne (A.C.) Gielen & Owen (O.A.) O'Donnell, 2018. "Earnings responses to disability benefit cuts," Tinbergen Institute Discussion Papers 18-023/V, Tinbergen Institute.
    12. Pierre Cahuc & Stéphane Carcillo & Bérengère Patault & Flavien Moreau, 2024. "Judge Bias in Labor Courts and Firm Performance," Journal of the European Economic Association, European Economic Association, vol. 22(3), pages 1319-1366.
    13. David C. Stapleton & Yonatan Ben-Shalom & David R. Mann, "undated". "The Employment/Eligibility Service System: A New Gateway for Employment Supports and Social Security Disability Benefits," Mathematica Policy Research Reports d8835946ad2743028b4b7acfc, Mathematica Policy Research.
    14. Sofia Amaral & Gordon B. Dahl & Victoria Endl-Geyer & Timo Hener & Helmut Rainer, 2023. "Deterrence or Backlash? Arrests and the Dynamics of Domestic Violence," NBER Working Papers 30855, National Bureau of Economic Research, Inc.
    15. Don Drummond & Evan Capeluck & Matthew Calver, 2015. "The Key Challenge for Canadian Public Policy: Generating Inclusive and Sustainable Economic Growth," CSLS Research Reports 2015-11, Centre for the Study of Living Standards.
    16. David R. Mann & Arif Mamun & Jeffrey Hemmeter, 2013. "Employment, Earnings, and Primary Impairments Among Beneficiaries of Social Security Disability Programs," Mathematica Policy Research Reports 63edd5c75c2e42baa4dcd9a23, Mathematica Policy Research.
    17. Lindner Stephan & Burdick Clark & Meseguer Javier, 2017. "Characteristics and Employment of Applicants for Social Security Disability Insurance over the Business Cycle," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 17(1), pages 1-17, February.
    18. Andreas I. Mueller & Jesse Rothstein & Till M. von Wachter, 2016. "Unemployment Insurance and Disability Insurance in the Great Recession," Journal of Labor Economics, University of Chicago Press, vol. 34(S1), pages 445-475.
    19. Manasi Deshpande & Yue Li, 2019. "Who Is Screened Out? Application Costs and the Targeting of Disability Programs," American Economic Journal: Economic Policy, American Economic Association, vol. 11(4), pages 213-248, November.
    20. Eric French & Jae Song, 2014. "The Effect of Disability Insurance Receipt on Labor Supply," American Economic Journal: Economic Policy, American Economic Association, vol. 6(2), pages 291-337, May.

    More about this item

    Keywords

    long-term care; policy evaluation; instrumental variables;
    All these keywords.

    JEL classification:

    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation
    • I10 - Health, Education, and Welfare - - Health - - - General

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:tin:wpaper:20180060. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Tinbergen Office +31 (0)10-4088900 (email available below). General contact details of provider: https://edirc.repec.org/data/tinbenl.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.