Impact of formal care consumption on informal care use in Europe: What is happening at the beginning of dependency?

Abstract

Little is known about care use decisions at the beginning of the disability process, when older people are vulnerable. This article investigates the impact of formal care (FC) consumption on informal care (IC) utilization in Europe in a population of frail older people. We use data from the Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT) study, which involves a sample of 1515 elderly (70+) people surveyed in 11 European countries. We explore the impact of home-based FC use on IC use at the extensive and intensive margins. The use of FC is instrumented with a dichotomous variable reproducing the eligibility criteria for public home-based FC in each country. We show that receiving home-based FC positively and significantly affects the probability of using IC. Therefore, we conclude that home-based FC and IC are complementary at the beginning of the dependency process.

Keywords: Formal care; Frailty; Informal care; Instrumental variable models; Long term care.