Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival

J Health Econ. 2020 Sep:73:102354. doi: 10.1016/j.jhealeco.2020.102354. Epub 2020 Jul 6.

Abstract

Encouraging and helping elderly to postpone a nursing home admission appears to be a win-win that keeps long-term care spending in check and is in line with the target population's preferences, but there is little evidence about its effects. We study the causal impact of nursing home admission eligibility using Dutch administrative data and exploiting variation between randomly assigned assessors in their tendency to grant eligibility for a nursing home admission. We find a drop in medical care use when eligibility is granted, especially in hospital admissions, while total healthcare spending is unaffected. This suggests that postponing an admission may not always be a win-win after all.

Keywords: Instrumental variables; Long-term care; Policy evaluation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Costs and Cost Analysis
  • Eligibility Determination
  • Hospitalization*
  • Humans
  • Long-Term Care
  • Nursing Homes*