Informal Care and Formal Home Care Use in Europe and the United States

The provision of informal care by adult children is an important form of long-term care for older individuals and can reduce the use of medical services if they are substitutes. We examine how informal care by all children and formal care interact, which is critically important given demographic trends and the many policies proposed to promote informal care. The purpose of this study is to compare the United States and European countries, by merging data from the U.S. Health and Retirement Study (HRS) with its European counterpart, the Survey of Health, Ageing and Retirement in Europe (SHARE). We argue that the institutional setting is different across the Atlantic, as European home care schemes are predominantly publicly run, whereas the market plays a bigger role in the United States. We use a fexible simultaneous equations approach that allows for a different relationship between informal and formal home care in the two regions, using couples. We find that in Europe it is predominantly the supply of formalhome care that influences decisions by children to provide informal care, while in the United States parents' decisions to use formal home care are based on the amount of informal care received and the amount of informal care provided by children is dependent on the amount of formal care.

Home Care Services/Informal caregiving/Informal caregiving/SHARE/Families/Transfers

25950