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• W2891960338 abstract "Dans les pays de l’OCDE, le vieillissement demographique et la prevalence croissante de maladies chroniques induisent un accroissement marque des effectifs de personnes âgees dependantes. Repondre a la preoccupation societale concernant l’accompagnement des personnes en incapacite dans un contexte de pression sur les finances publiques constitue un defi majeur pour les politiques publiques. Comment les dispositifs publics visant a financer les soins de longue duree affectent les aides formelles et informelles recues par les personnes en situation d’incapacite ? La distribution des aides medico-sociales et des restes-a-charge est-elle equitable ? Comment ameliorer l’efficience et l’equite des dispositifs publics ? Cette these apporte un eclairage sur ces questions en mobilisant les outils conceptuels de la microeconomie et les methodes de l’economie appliquee. Elle rassemble quatre investigations empiriques menees a partir de donnees francaises et neerlandaises recentes. Les 3 premiers chapitres traitent du cas francais. Le chapitre 1 etudie la distinction faite entre adultes handicapes et personnes âgees dependantes. Il evalue l’effet de la « barriere des 60 ans » sur les aides formelles et informelles recues. Les chapitres 2 et 3 se focalisent sur le dispositif-phare destine aux personnes âgees dependantes, l’Allocation personnalisee d’autonomie (APA). Le chapitre 2 estime les elasticites prix et revenu de la demande d’aide a domicile des beneficiaires de l’APA. Le chapitre 3 evalue l’equite dans l’utilisation des aides et des restes-a-charge dans le cadre de l’APA. Le chapitre 4 evalue l’equite horizontale dans l’utilisation de soins de longue duree aux Pays-Bas. Les subventions sur l’aide a domicile induisent des ajustements dans la consommation d’aide via des effets de revenu et de substitution, ce qui a des implications pour l’efficience de ces dispositifs. Des iniquites sont detectees dans les deux pays.In OECD countries, population ageing and the increasing prevalence of some chronic diseases cause a substantial increase in the number of the disabled elderly. Responding to both the societal concern for ensuring appropriate longterm care (LTC) to the disabled and the pressure on public spending is a major challenge for public policies. How do public LTC schemes affect the use of formal and informal care by the disabled? Are there socio-economic disparities in the use of formal care? Is the allocation of LTC services and of the out-of-pocket payments incurred by the disabled elderly equitable? Which features of LTC policies could be changed to make them more efficient and more equitable? My research sheds light on these questions, using conceptual tools from microeconomics and methods in applied economics. It brings together four empirical investigations led in the contexts of France and the Netherlands, which have contrasting LTC systems. I make use of recent administrative and survey microdata. The first three Chapters focus on French policies. Chapter 1 studies the distinction that is made between the handicapped adults and the dependent elderly in access to public LTC support. It assesses the effect of the “age 60 threshold” on the formal and informal care received by individuals with a disability. Chapters 2 and 3 concentrate on the main scheme accessible to the disabled elderly, the Allocation personnalisee d’autonomie (APA). Chapter 2 estimates the income and price elasticities of formal home care demand by APA beneficiaries. Chapter 3 assesses equity in the use and financing of home care within the APA scheme. Chapter 4 lands in the Netherlands and assesses income-related horizontal equity in LTC use. Home care subsidies trigger adjustments in the use of care through both substitution and income effects. This has implications for the efficiency of such policies. Some inequity is detected in both countries." @default.
• W2891960338 created "2018-09-27" @default.
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• W2891960338 date "2018-06-20" @default.
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• W2891960338 title "Equity and efficiency in long-term care policies: empirical evidence from France and the Netherlands" @default.
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