Financing long-term care: ex ante, ex post or both?

Health Economics
Joan Costa-FontKatherine Swartz

Abstract

This paper attempts to examine the heterogeneity in the public financing of long-term care (LTC) and the wide-ranging instruments in place to finance LTC services. We distinguish and classify the institutional responses to the need for LTC financing as ex ante (occurring prior to when the need arises, such as insurance) and ex post (occurring after the need arises, such as public sector and family financing). Then, we examine country-specific data to ascertain whether the two types of financing are complements or substitutes. Finally, we examine exploratory cross-national data on public expenditure determinants, specifically economic, demographic and social determinants. We show that although both ex ante and ex post mechanisms exist in all countries with advanced industrial economies and despite the fact that instruments are different across countries, ex ante and ex post instruments are largely substitutes for each other. Expenditure estimates to date indicate that the public financing of LTC is highly sensitive to a country's income, ageing of the population and the availability of informal caregiving.

References

Mar 30, 2006·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Peter KemperLisa Alecxih
Apr 17, 2007·Journal of Aging & Social Policy·Mark R MeinersKevin J Mahoney
Jan 6, 2010·Health Affairs·David G StevensonBrian Burwell
Dec 20, 2011·Journal of Policy Analysis and Management : [the Journal of the Association for Public Policy Analysis and Management]·Katherine SwartzNadine Farag
Mar 12, 2015·Health Economics·Joan Costa-Font, Christophe Courbage
Mar 12, 2015·Health Economics·Sarah Karlsberg Schaffer

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Citations

Mar 12, 2015·Health Economics·Joan Costa-Font, Christophe Courbage
Mar 12, 2015·Health Economics·Claudine de MeijerMarc Koopmanschap
Jan 1, 2018·De Economist·Nicola Ciccarelli, Arthur Van Soest
Oct 24, 2018·BMC Geriatrics·Live Bredholt JørgensenAnne-Sofie Helvik
May 1, 2021·International Journal of Environmental Research and Public Health·Beatriz Rodríguez-SánchezDavid Cantarero-Prieto
Jul 17, 2021·Journal of the American Medical Directors Association·Mauricio Matus-López, Alexander Chaverri-Carvajal
Oct 19, 2019·Journal of the American Medical Directors Association·Huei-Ru Lin, Yuichi Imanaka

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