Projet ANR-06-JCJC-0022 – EconCare : Economics of formal and informal care for an ageing population
Programme : Programme "Jeunes chercheuses et jeunes chercheurs" (JCJC) 2006
Année de financement : 2006
Coordinateur du projet : INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE - DELEGATION PACA (INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE - DELEGATION PACA)
Partenaires : Institut national de la santé et de la recherche médicale
Montant : 80000.0 euros
Date de début : 2006
Durée : 36 mois
Résumé : Scientific background and objectives. The terms of economic growth basically depend on population ageing, which is commonly assumed to induce sharp increases in healthcare expenditures. More basically, macroeconomic impact of ageing lies in distributive mechanisms across generations induced by ageing and, at the core, in inter and intrafamily intergenerational transfers, monetary (such as bequests to younger generations, contributions to pensions or health insurance by the working-age population or out-of-pocket payments for professional help to elderly) or non-monetary (through providing of informal assistance from children to elderly). The place given by younger generations to the elderly reveals after demographic, epidemiologic and economic transitions, a societal one where the oldest, instead of the youngest, are at the very core of the concern of modern societies. First, the research is aimed at taking benefit from epidemiological models on the disablement process to better understand why and when the elderly will be likely to need personal assistance in one or more activities of daily living (ADL) whereas some other elderly, with the same impairments or diseases, will not. It will try to assess on a hourly and monetary basis human help reported by the elderly and whether these needs are met or not. Second, the research will have to deal with a methodological issue strongly overlapped to the former point and lying in participation and selection biases. In population surveys, all the more in health and disability surveys, there is a strong presumption of self-report endogeneity to respondents' health status. However, to the best of our knowledge, attempts to use appropriate methods both to investigate the determinants of met and unmet needs and to assess the hourly and the monetary value of actual needs are very scarce whereas addressing such a point is again of a great relevance for the design of policies organising the supply of assistance for elderly. Third, the main feature of informal care that children, families or relatives may supply to their elder parents is to be both inescapable and insufficiently considered. The latter goal of that research will be to make more explicit the kind of motivations (pure or impure altruism, expectations of future bequests, implicit comparisons of opportunity costs of care supply to payments of professional assistance) of informal helpers. It will be possible through giving economic values for informal care, by the way by linking them to family composition, socioeconomic status and of course health status, with the help of a range of methods among which proxy good or market cost methods and contingent valuation.  Description of project, methodology. That proposal includes both conceptual and theoretical research and empirical ambitions. At the theoretical level, it is aimed at explaining rationing phenomena in personal services and healthcare demand, as well as building intergenerational utility models implying altruism and/or economic rationality to explain informal care given by children to elderly parents. At the empirical level, applied findings will use data from the French National Survey named "Handicaps, Incapacités, Dépendance" (HID). That survey has been conducted by the National Institute for Statistics and Economic Studies (Insee) in France from 1998 to 2001, both in institutions (1998 and 2000) and in the community (1999 and 2001). It examined the consequences of health problems on physical and psychological functioning and on the daily and social life of persons living at home. Empirical research will also use data of the forthcoming "Handicap-Santé" survey which will sum up the previous "Enquête Décennale Santé" and "HID" surveys and has to be run by Insee in 2007/8. That new survey is prepared in workshops which researchers of Inserm Research Unit 379 regularly contribute to.  Expected results. That research program takes place in a general context of potentially cont