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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 vary 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 vary 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 36/100
Published in a peer-reviewed journal. 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 journal's citation record and impact for its field and year, so those were left out: it earned 32 of the 90 points we could judge it on, which is 36 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Not indexed) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| 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 | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| 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 | 2 / 7 | Cited 5 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 5 year(s) since 2023 |
| 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 | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Marie‐Louise Leroux: h-index 18 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Centre National de la Recherche Scientifique: institution h-index 2,511 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 3 countries |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 32 / 90 | Scored on 18 of 20 parts. We have no data for the rest, so they are left out: 32 of the 90 points we could judge it on is 36 out of 100. |
| Total | 36 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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/10.54932/qcpf8093
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:10.54932/qcpf8093.
BibTeX
@article{achou2023-ca65127c,
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 = {10.54932/qcpf8093},
url = {https://doi.org/10.54932/qcpf8093}
}
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