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Does independent needs assessment limit supply-side moral hazard in long-term care?

Author

Listed:
  • Rudy Douven

    (CPB Netherlands Bureau for Economic Policy Analysis)

  • Pieter Bakx
  • Frederik T. Schut
Abstract
The decision about the amount and type of care that a patient needs may be entrusted to health care providers or be delegated to an independent assessor. An independent assessment limits the scope for supply-side moral hazard and occurs frequently in long-term care (LTC), e.g. in the Netherlands, Germany, Belgium, Switzerland, and Japan. The characteristics of LTC, the potential lack of incentives for efficient use for consumers, providers and third-party payers, and the absence of other restrictions of supply and demand, suggest that there may be room for excessive LTC use in the Netherlands, so there might be a case for independent needs assessment. Unique individual level data about LTC-eligibility decisions and use show that consumers make use of the indicated type of care but that for virtually all subgroups in the population there is considerable non-take-up, meaning that the independent assessment does not limit the amount of care that patients use. This finding suggests that the independent needs assessment may only have a small effect on preventing supply-side moral hazard in LTC.

Suggested Citation

  • Rudy Douven & Pieter Bakx & Frederik T. Schut, 2016. "Does independent needs assessment limit supply-side moral hazard in long-term care?," CPB Discussion Paper 327, CPB Netherlands Bureau for Economic Policy Analysis.
    • Handle: RePEc:cpb:discus:327
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    References listed on IDEAS

    as
    1. Arrighi, Yves & Davin, Bérengère & Trannoy, Alain & Ventelou, Bruno, 2015. "The non-take up of long-term care benefit in France: A pecuniary motive?," Health Policy, Elsevier, vol. 119(10), pages 1338-1348.
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    7. repec:dau:papers:123456789/9715 is not listed on IDEAS
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    Full references (including those not matched with items on IDEAS)

    Citations

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    Cited by:

    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).
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    3. Daisy Duell & Maarten Lindeboom & Xander Koolman & France Portrait, 2019. "Practice variation in long‐term care access and use: The role of the ability to pay," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1277-1292, November.
    4. 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.
    5. Marielle Non, 2017. "Co-payments in long-term home care: do they affect the use of care?," CPB Discussion Paper 363.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    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.

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    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L13 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Oligopoly and Other Imperfect Markets
    • L33 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - Comparison of Public and Private Enterprise and Nonprofit Institutions; Privatization; Contracting Out

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