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The impact of long-term care on quality of life

Forder, Julien, Vadean, Florin, Rand, Stacey, Malley, Juliette (2017) The impact of long-term care on quality of life. Health Economics, 27 (3). e43-e58. ISSN 1057-9230. E-ISSN 1099-1050. (doi:10.1002/hec.3612) (KAR id:63581)

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Abstract

Long-term care (LTC) services are provided to help people manage the consequences of impairment, but their impact goes beyond the meeting of basic needs. Accordingly, the main aim was to explore the marginal effectiveness of care when measured in terms of people’s overall care-related quality of life (CRQoL) and assess changes in marginal effect for increasing intensity. The associated aim was to refine and apply an observational method to estimate marginal effectiveness. A ‘production-function’ approach was used with survey data, including ASCOT-measured CRQoL, whereby we statistically modelled the expected relationship between service utilisation rates and CRQoL. This method seeks to limit endogeneity issues by controlling on observables and using instrumental variable (IV). Using a survey of publicly-funded long-term care service users in England, we found that community-based LTC significantly improved people’s CRQoL but with diminishing marginal effects and effects differentiated by baseline impairment levels. There are implications for how the care system should respond to changes in global public budgets. For example, where there is unmet need, a system aimed to maximise (unadjusted) CRQoL would put more emphasis on access (more recipients) than intensity of support compared to a system operating on a needs basis.

Item Type: Article
DOI/Identification number: 10.1002/hec.3612
Uncontrolled keywords: long-term care; quality of life; production functions; instrumental variables estimation
Subjects: H Social Sciences
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Personal Social Services Research Unit
Depositing User: Julien Forder
Date Deposited: 26 Sep 2017 14:44 UTC
Last Modified: 06 Feb 2020 04:16 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/63581 (The current URI for this page, for reference purposes)
Forder, Julien: https://orcid.org/0000-0001-7793-4328
Vadean, Florin: https://orcid.org/0000-0001-7882-3400
Rand, Stacey: https://orcid.org/0000-0001-9071-2842
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