Local Variability in Long-Term Care Services: Local Autonomy, Exogenous Influences and Policy Spillovers

In many countries, public responsibility over the funding and provision of long‐term care services is held at the local level. In such systems, long‐term care provision is often characterised by significant local variability. Using a panel dataset of local authorities over the period 2002–2012, the...

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Bibliographic Details
Published in:Health economics 2015-03, Vol.24 (S1), p.146-157
Main Authors: Fernandez, José-Luis, Forder, Julien
Format: Article
Language:English
Subjects:
Aged
Expenditures
Health care expenditures
Health economics
Health Expenditures - statistics & numerical data
Health Policy - economics
Health Services for the Aged - economics
Health Services for the Aged - statistics & numerical data
Humans
Impact analysis
Local Government
Long term care insurance
Long term health care
long-term care
Long-Term Care - economics
Long-Term Care - statistics & numerical data
Models, Theoretical
Older people
Public policy
Social Welfare - economics
Social Welfare - statistics & numerical data
spatial
spillovers
Studies
Supply & demand
United Kingdom
variability
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Summary:In many countries, public responsibility over the funding and provision of long‐term care services is held at the local level. In such systems, long‐term care provision is often characterised by significant local variability. Using a panel dataset of local authorities over the period 2002–2012, the paper investigates the underlying causes of variation in gross social care expenditure for older people in England. The analysis distinguishes between factors outside the direct control of policy makers, local preferences and local policy spillovers. The results indicate that local demand and supply factors, and to a much lesser extent local political preferences and spatial policy spillovers, explain a large majority of the observed variation in expenditure. Copyright © 2015 John Wiley & Sons, Ltd.
ISSN:1057-9230
1099-1050
DOI:10.1002/hec.3151