β Scribed by France Weaver; Sally C. Stearns; Edward C. Norton; William Spector
No coin nor oath required. For personal study only.
The extent to which increasing longevity increases per capita demand for longβterm care depends on the degree to which utilization is concentrated at the end of life. We estimate the marginal effect of proximity to death, measured by being within 2 years of death, on the probabilities of nursing home and formal home care use, and we determine whether this effect differs by availability of informal care β i.e. marital status and coβresidence with an adult child. The analysis uses a sample of elderly aged 70+from the 1993β2002 Health and Retirement Study. Simultaneous probit models address the joint decisions to use longβterm care and coβreside with an adult child. Overall, proximity to death significantly increases the probability of nursing home use by 50.0% and of formal home care use by 12.4%. Availability of informal support significantly reduces the effect of proximity to death. Among married elderly, proximity to death has no effect on institutionalization. In conclusion, proximity to death is one of the main drivers of longβterm care use, but changes in sources of informal support, such as an increase in the proportion of married elderly, may lessen its importance in shaping the demand for longβterm care. Copyright Β© 2008 John Wiley & Sons, Ltd.
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## Abstract ## Background Following the introduction of the public longβterm care (LTC) insurance in Japan on 1 April 2000, funding that had been split between the health and social welfare sectors was unified. All elderly people 65 and over have become entitled to receive benefits according to th