Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data
利用荷兰关联调查和行政数据，研究发现非正式照料对严重功能障碍者增加三年内入住养老院概率和正式居家护理成本，对轻度障碍者降低总护理成本，但降低养老院入住的效果不明确。
We assess whether informal care receipt affects the probability of transitioning to a nursing home. Available evidence derives from the US, where nursing home stays are often temporary. Exploiting linked survey and administrative data from the Netherlands, we use the gender mix of children to retrieve exogenous variation in informal care receipt. We find that informal care increases the chance of an admission within a three-year period for individuals with severe functional limitations, and increases the costs incurred on formal home care. For individuals with mild limitations, informal care substantially decreases total care costs, whereas its effect on nursing home admission is unclear. Further, informal care results in lower post-acute care use and hospital care costs, and does not increase mortality. Promoting informal care cannot be expected to systematically result in lower institutionalization rate and care costs, but it may nonetheless induce health benefits for its recipients.