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The impact of long-term care on primary care doctor consultations for people over 75 years

Forder, Julien E., Gousia, Katerina, Saloniki, Eirini-Christina (2019) The impact of long-term care on primary care doctor consultations for people over 75 years. European Journal of Health Economics, 20 (3). pp. 375-387. ISSN 1618-7598. (doi:10.1007/s10198-018-0999-6)

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Abstract

Many countries are adopting policies to create greater coordination and integration between acute and long-term care services. This policy is predicated on the assumption that these service areas have interdependent outcomes for patients. In this paper we study the interdependencies between the long-term (home care) services and eqpuwnvcvkqpu"ykvj"c"rtkoct{"ectg"fqevqt."cu"wugf"d{"rgqrng"qxgt"970"Uvctvkpi"ykvj"c"oqfgn"qh"kpfkxkfwcnÓu"fgocpf" for doctor consultations, given supply, we formalize the hypothesis that exogenous increases to home care supply will reduce the number of consultations where these services are technical substitutes. Furthermore, greater coordination of public service planning and use of pooled budgets could lead to better outcomes because planners can account for these externalities. We test our main hypothesis using data from the British Household Panel Study for 1991-2009. To address potential concerns about endogeneity we use a set of instrumental variables for home care motivated by institutional features of the social care system. We find that there is a statistically significant substitution effect between home care and doctor visits, which is robust across a range of specifications. This result has implications for policies that consider increased coordination between health care and social care systems.

Item Type: Article
DOI/Identification number: 10.1007/s10198-018-0999-6
Uncontrolled keywords: substitution, social care, primary care, older people
Subjects: H Social Sciences
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research
Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Personal Social Services Research Unit
Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Eirini Saloniki
Date Deposited: 07 Sep 2018 10:56 UTC
Last Modified: 24 Jun 2019 09:05 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/68984 (The current URI for this page, for reference purposes)
Forder, Julien E.: https://orcid.org/0000-0001-7793-4328
Gousia, Katerina: https://orcid.org/0000-0002-2494-786X
Saloniki, Eirini-Christina: https://orcid.org/0000-0002-5867-2702
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