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Willingness-to-pay for reductions in care need: estimating the value of informal care in Alzheimer's disease
- Authors:
- GUSTAVSSON Anders, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(6), June 2010, pp.622-632.
- Publisher:
- Wiley
This study attempted to estimate the value of informal care in Alzheimer's disease patients using contingent valuation. Five hundred and seventeen primary carers in four countries (UK, Spain, Sweden, and US) were administered a questionnaire. Carers estimated the amount they were willing to pay for a reduction in care burden by 1 hour per day, or a total elimination of care needs. Further, the relationship between carer willingness to pay and carer and patient characteristics including disease severity and income was examined. Findings showed that carers spend on average 7 to 9 hours per day on giving care to their patient, of which 4 to 5 hour constituted basic and instrumental activities of daily living. For a 1 hour reduction in care per day, carers said that they were willing to pay £105, £121, £59, and £144 per month in the UK, Spain, Sweden, and US respectively. The willingness to pay was higher for carers with higher disposable income while the influence of other factors varied across countries. About one-third of carers were not willing to pay anything for a reduction in care. The authors concluded that carers’ stated willingness to pay for reductions in care giving time is substantial and comparable to the prices currently paid for treatments that achieve this benefit. Its determinants seem more directly related to carer status than directly to patient status and may vary by region and by cultural and sociologic factors.
Means testing and the heterogeneity of housing assets: funding long-term care in Spain
- Authors:
- COSTA-FONT Joan, MARSCARILLA-MIRO Oscar, ELVIRA David
- Journal article citation:
- Social Policy and Administration, 40(5), October 2006, pp.543-559.
- Publisher:
- Wiley
The access to publicly funded long-term care (LTC) in Spain has been traditionally rationed through the use of means tests based on individuals' current income and needs. However, individuals' wealth, primarily housing assets, is progressively taken into account. Parallel to this feature, the responsibilities for the organization of LTC services have been devolved to region-states – autonomous communities (ACs), giving rise to some regional heterogeneity, though limited evidence has been reported on the underlying determinants. This paper examines the current role of housing assets in determining public and private funding for long-term care in Spain. Secondly, we present a qualitative and quantitative examination of the regional heterogeneity in the provision and public funding criteria determining eligibility for public support for LTC. Finally, we report survey evidence on the individual's willingness to sell (WTS) their housing assets in order to either totally or partially finance the access to LTC. Our findings suggest that housing assets are the main source of wealth accumulation at old age. Yet there is significant regional heterogeneity in the access to LTC resulting from regional differences in the means testing criteria. Progressively, all ACs are considering housing assets in their means testing criteria. Interestingly, individuals' willingness to sell their housing assets declines with age and is more common among less skilled and widowed individuals.
A comparative case study of care systems for frail elderly people: Germany, Spain, France, Italy, United Kingdom and Sweden
- Authors:
- LE BIHAN Blanche, MARTIN Claude
- Journal article citation:
- Social Policy and Administration, 40(1), February 2006, pp.26-46.
- Publisher:
- Wiley
Comparative studies of European social policies towards frail elderly people typically focus on the systems and their implementation. The study presented in this article, conducted in 2001 in six European countries (Germany, Spain, Italy, France, the United Kingdom and Sweden) aims at comparing the rights of the individuals within the different care systems. The methodology used is a case study approach, which draws on a series of situations of dependent elderly people. The analysis focuses on the public authorities' responses – the care packages, which determine the type of care required and the financial contribution of the user – in each of the six countries, in relation to the concrete situations of frail elderly people. As local variations are important, in all the countries studied, local authorities have been chosen in each of the countries. This approach provides interesting concrete elements on the services and financial help which can be given to frail elderly people, and provides an understand of the national care systems organized in the different countries and the main difficulties encountered by public authorities in facing this problem of frail elderly people.
Family care of the older elderly: Spain
- Author:
- RODRIGUEZ Josep
- Publisher:
- European Foundation for the Improvement of Living and Working Conditions
- Publication year:
- 1993
- Pagination:
- 65p.,tables.
- Place of publication:
- Dublin
Describes the situation of older people and their carers in France. Looks at socio-demographic data, family structure, and looks at the carers themselves and the services available to them.