Proximity to death and participation in the long-term care market.

TitleProximity to death and participation in the long-term care market.
Publication TypeJournal Article
Year of Publication2009
AuthorsWeaver, F, Stearns, SC, Norton, EC, Spector, W
JournalHealth Econ
Date Published2009 Aug
ISSN Number1099-1050
Call Numbernewpubs20090908_Weaver_etal.pdf
KeywordsAged, Aged, 80 and over, Caregivers, Female, Health Services Needs and Demand, Home Care Services, Humans, Interviews as Topic, Longevity, Male, Models, Statistical, Nursing homes, Terminal Care, United States

The extent to which increasing longevity increases per capita demand for long-term care depends on the degree to which utilization is concentrated at the end of life. We estimate the marginal effect of proximity to death, measured by being within 2 years of death, on the probabilities of nursing home and formal home care use, and we determine whether this effect differs by availability of informal care--i.e. marital status and co-residence with an adult child. The analysis uses a sample of elderly aged 70+ from the 1993-2002 Health and Retirement Study. Simultaneous probit models address the joint decisions to use long-term care and co-reside with an adult child. Overall, proximity to death significantly increases the probability of nursing home use by 50.0% and of formal home care use by 12.4%. Availability of informal support significantly reduces the effect of proximity to death. Among married elderly, proximity to death has no effect on institutionalization. In conclusion, proximity to death is one of the main drivers of long-term care use, but changes in sources of informal support, such as an increase in the proportion of married elderly, may lessen its importance in shaping the demand for long-term care.


PMID: 18770873

User Guide Notes

Endnote Keywords

Long-Term Care/Longevity/Nursing Homes/Home Nursing

Endnote ID


Alternate JournalHealth Econ
Citation Key7345
PubMed ID18770873
PubMed Central IDPMC3786420
Grant ListP30 AG024376 / AG / NIA NIH HHS / United States