2nd cycle – Webinar 2

2nd cycle – INNOVCARE Webinar n°2

Wednesday 30 November 2022, 9 am to 11 am (France) / 5 pm to 7 pm (Japan) – Online

  • Quitterie Roquebert, BETA, Université de Strasbourg – Informal care at old age at home and in nursing homes: determinants and economic value
  • Yasuhiro Nakanishi, Nara Medical University – Forecasting the Regional Distribution of Home Care Patients Using Big Data of Insurance Claims in Japan: 2015 to 2045

Informal care at old age at home and in nursing homes: determinants and economic value – Quitterie Roquebert (BETA, Université de Strasbourg) and Marianne Tenand (CPB, ESHPM, EsCHER)

This paper provides a comprehensive analysis of informal care receipt by the French individuals aged 60 or older. The literature has focused on the community, leaving informal care in residential care settings in the shadow. We leverage data from a representative survey (CARE) conducted in 2015-2016 on both community-dwelling individuals and nursing home residents. Focusing on the 60+ with activity restrictions, we show that 76% of nursing home residents receive help with the activities of daily living from relatives, against 55% in the community. The number of hours conditional on receipt is yet 3.5 times higher in the community. Informal care represents 186 million hours per month and a value equivalent to 1.1% of GDP, care in the community representing 95% of the total.
We investigate the determinants of informal care receipt. Using an Oaxaca-type approach, we disentangle between two mechanisms explaining differences observed across settings, namely the differences in population composition (endowments) and the differences in the association of individual characteristics with informal care (coefficients). They are found to have a similar contribution at the extensive margin.
Our results imply that private costs make up for the majority (76%) of the costs associated with long-term care provision once informal care is taken into account. They also highlight that informal care is extremely common for nursing home residents. Existing evidence on the determinants of informal care receipt in the community has however limited relevance to understand informal care behaviors in nursing homes.


Forecasting the Regional Distribution of Home Care Patients Using Big Data of Insurance Claims in Japan: 2015 to 2045 – Yasuhiro Nakanishi (Nara Medical University)

Regional distribution of home care patients and future demand in Japan are unknown. This study aimed to reveal the actual situation of home care patients by region and forecast demand up to 2045. Linked complete health and long-term care insurance claims data on Nara Prefecture (around 1% of the total population and area of Japan) patients aged 75 years or older who received planned and/or urgent medical treatment by physician home visit between April 2015 and March 2016 were extracted and analyzed by sex, age group, and municipality. We calculated the proportion of home medical care utilization and projected the number of home care patients for every five-year period up to 2045 across five administrative areas of the medical service in Nara Prefecture. Data on 12,656 patients, including 1,455 aged 75–79 years, 2,753 aged 80–84, 3,854 aged 85–89, and 4,594 aged 90 years or older, were extracted. The current proportion of patients receiving home medical care (unadjusted for age) by medical service administrative area showed a difference of up to 1.6 times for those aged 90 years or older. Results of forecasting showed a marked increase in the number of patients aged 90 years or older, with overall numbers continuing to increase up to 2040, reaching a maximum of around 25,759 then decreasing thereafter. The future increase in home care patient numbers could vary by age and area, and our findings suggest that public health policy based on the future demand in each area will be required.

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