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At Home Versus in a Nursing Home: Long-Term Care Settings and Marginal Utility
Bertrand Achou, Philippe De Donder, Franca Glenzer, Minjoon Lee, Marie-Louise Leroux. Not indexed, 2023
Topic: Risk, prevention and care in population studies
Marginal utility of financial resources when needing long-term care, and the related incentives for precautionary savings and insurance, may vary significantly by whether one receives care at home or in a nursing home. In this paper, we develop strategic survey questions to estimate those differences. All else equal, we find that the marginal utility is significantly higher when receiving care at home rather than in a nursing home. We then use these estimates within a quantitative life cycle model to evaluate the impact of the expected choice of care setting (home versus nursing home) on precautionary savings and insurance valuation. The estimated marginal utility differences imply a significant increase in the incentives to save when expecting to receive care at home. Larger incentives to self-insure also translate to a higher valuation of additional subsidies for home care than for nursing homes, shedding light on an efficient way to expand public long-term care subsidies. We also examine how the magnitude of our results quantitatively varies with the existing public long-term care subsidies.
Key findings
- Marginal utility of financial resources when needing long-term care, and the related incentives for precautionary savings and insurance, may vary significantly by whether one receives care at home or in a nursing home.
- All else equal, we find that the marginal utility is significantly higher when receiving care at home rather than in a nursing home.
- We then use these estimates within a quantitative life cycle model to evaluate the impact of the expected choice of care setting (home versus nursing home) on precautionary savings and insurance valuation.
- The estimated marginal utility differences imply a significant increase in the incentives to save when expecting to receive care at home.
- We also examine how the magnitude of our results quantitatively varies with the existing public long-term care subsidies.
Why it matters
This economic analysis found that the marginal utility of financial resources is significantly higher when care is received at home rather than in a nursing home. This implies stronger incentives to save for those expecting home care and a higher value for additional home care subsidies than for nursing home subsidies.
Study details
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 16 on the same rubric, which is below the 16 cap we apply to non-peer-reviewed sources. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 11 of the 68 points we could judge it on, which is 16 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Not indexed) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 11 / 68 | Scored on 13 of 20 parts. We have no data for the rest, so they are left out: 11 of the 68 points we could judge it on is 16 out of 100. |
| Total | 16 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. This record has no journal, so the citation leaves it out. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Achou, B., De Donder, P., Glenzer, F., Lee, M., & Leroux, M.-L. (2023). At Home Versus in a Nursing Home: Long-Term Care Settings and Marginal Utility. https://doi.org/10.2139/ssrn.4472925
Vancouver
Achou B, De Donder P, Glenzer F, Lee M, Leroux M.-L. At Home Versus in a Nursing Home: Long-Term Care Settings and Marginal Utility. 2023. doi:10.2139/ssrn.4472925.
BibTeX
@article{achou2023-79ebd2bd,
author = {Achou, Bertrand and De Donder, Philippe and Glenzer, Franca and Lee, Minjoon and Leroux, Marie-Louise},
title = {{At Home Versus in a Nursing Home: Long-Term Care Settings and Marginal Utility}},
year = {2023},
doi = {10.2139/ssrn.4472925},
url = {https://doi.org/10.2139/ssrn.4472925}
}
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