Cristina Vilaplana Prieto

The trade-off between formal and informal care in Spain

Understanding the factors that determine the type and amount of formal care is important for predicting use in the future and developing long-term policy. In this context, we jointly analyze the provision of care at both the extensive (choice of care) and the intensive margin (number of hours of care received). In particular, we estimate and test, for the first time in this area of research, a sample selection model with the particularities that the first step is a multinomial logit model and the hours of care is an interval variable. Our results support the complementary and task-specific models which evidence has been found in other countries. Furthermore, we obtain evidence of substitution between formal and informal care for the male, young, married and unmarried subsamples. Regarding the hours of care, we find significant biases in predicted hours of care when sample selection is not taken into account. For the whole sample, the average bias is 2.77% for total hours and 3.23% for formal care hours. However, biases can be much larger (up to 10–15%), depending on the subsample and the type of care considered.

Award Errors and Permanent Disability Benefits in Spain

There is a controversial debate about the effects of permanent disability benefits on labor market behavior. In this paper we estimate equations for deserving and receiving disability benefits to evaluate the award error as the difference in the probability of receiving and deserving using survey data from Spain. Our results indicate that individuals aged between 55 and 59, self-employers or working in an agricultural sector have a probability of receiving a benefit without deserving it significantly higher than the rest of individuals. We also find evidence of gender discrimination since male have a significantly higher probability of receiving a benefit without deserving it. This seems to confirm that disability benefits are being used as an instrument for exiting the labor market for some individuals approaching the early retirement or those who do not have right to retire early. Taking into account that awarding process depends on Social Security Provincial Department, this means that some departments are applying loosely the disability requirements for granting disability benefits.

Trade-off entre cuidados formales e informales en Europa

OBJECTIVE To study the relationship between formal and informal care for the dependent population in a number of European countries. METHOD Data from the Survey of Health, Aging and Retirement in Europe for 2004 were used and a bivariate probit model was estimated. Unlike other studies, the present analysis includes the institutional features of the various long-term care systems, in addition to the demographic, health and environmental characteristics of the individual receiving care. RESULTS A significant correlation was found between the two options, which reveals that, conditional on receiving care, there was a preference for the combination of both types of care. The results show the importance of health status and living arrangements for defining the combination of formal and informal care. There were substantial differences in the likelihood of the two types of care among European countries. A notable finding was the importance of informal care in Spain in comparison with other countries. CONCLUSIONS The probability of receiving formal or informal care is higher in countries where families have a legal obligation to look after dependent relatives and where institutionalization rates are higher. This finding should be considered in the design of long-term care policies. Therefore, to control growth of public expenditure and, at the same time, improve caregiver satisfaction, policies that combine distinct formal services should be promoted over the implementation of care allowances.

La interacción del sistema social y el sanitario. Informe SESPAS 2012

Act 39/2006, of 14th December, for the Promotion of Personal Autonomy and the Care of Dependent Individuals establishes the basic conditions for the promotion of personal autonomy and the care of the dependent through the creation of the System of Autonomy and Care of Dependent Individuals and constitutes an excellent opportunity to make progress in the development of a health care space. The aim of healthcare integration is to move from a fragmented framework, in which individuals apply for and receive health benefits and care benefits separately, to a new model of shared responsibility. Since the 1980s, several national and regional projects of healthcare cooperation have been developed. However, although substantial efforts have been made in some autonomous regions of Spain, healthcare coordination seems to predominate over integration in the health setting.

[Trade-off between formal and informal care in Europe].

OBJECTIVE To study the relationship between formal and informal care for the dependent population in a number of European countries. METHOD Data from the Survey of Health, Aging and Retirement in Europe for 2004 were used and a bivariate probit model was estimated. Unlike other studies, the present analysis includes the institutional features of the various long-term care systems, in addition to the demographic, health and environmental characteristics of the individual receiving care. RESULTS A significant correlation was found between the two options, which reveals that, conditional on receiving care, there was a preference for the combination of both types of care. The results show the importance of health status and living arrangements for defining the combination of formal and informal care. There were substantial differences in the likelihood of the two types of care among European countries. A notable finding was the importance of informal care in Spain in comparison with other countries. CONCLUSIONS The probability of receiving formal or informal care is higher in countries where families have a legal obligation to look after dependent relatives and where institutionalization rates are higher. This finding should be considered in the design of long-term care policies. Therefore, to control growth of public expenditure and, at the same time, improve caregiver satisfaction, policies that combine distinct formal services should be promoted over the implementation of care allowances.

Unmet needs in formal care: kindling the spark for caregiving behavior

This paper studies if a situation of formal care unmet needs is a strong motivation for the onset of caregiving behavior, and if becoming caregiving is a compelling argument for leaving current job (in the presence/absence of formal care unmet needs). We use data from the Eurobarometer 67.3 for 18 European countries and estimate a three simultaneous equations model taking into account the potential endogeneity of labor participation and formal care unmet needs and assuming non-zero correlation among the error terms of the three equations. Results show that individuals who anticipate that becoming caregiver can suppose an obstacle for continuing working feel more refractory and are more prone to avoid caregiving responsibilities. Knowing someone with an unmet needs problem increases the probability of becoming caregiver by +19.23 pp (with a maximum of +39.39 pp for difficult access unmet needs) and raises the probability of leaving employment by 5.77 pp. Having to possibility of receiving economic benefits for caregivers encourage more labor market exit as compared to payment of social security contributions during care leaves.

Impacto sobre las cotizaciones sociales de la integración del Sistema Especial de Empleados del Hogar en el Régimen General: aplicación a los empleados que atienden a personas en situación de dependencia

Este trabajo aborda la integracion del sistema Especial de Empleados del Hogar en el Regimen General de la Seguridad Social utilizando informacion sobre empleados del hogar que atienden a personas dependientes. Se han comparado los efectos del Real Decreto 1620/2011 y Real Decreto-Ley 29/2012. Esta segunda reforma supone una reduccion del ahorro en las cuotas por contingencias comunes y profesionales de las que se beneficiaban empleados y empleadores con la primera reforma. Las simulaciones de ingresos de la Tesoreria de la Seguridad Social durante 2013-2019, en los diferentes escenarios, muestran un incremento de los ingresos con el segundo texto legislativo.