Volume 31, Number 3 (Summer) 1996
Pezzin, Liliana E., Peter Kemper, and James Reschovsky. 1996. "Does Publicly Provided Home Care Substitute for Family Care? Experimental Evidence with Endogenous Living Arrangements." Journal of Human Resources 31(3):650-676.
This paper analyzes the extent to which publicly pro vided formal (paid) home care substitutes for unpaid care provided informally by family and friends. Unlike most previous research, we recognize that the choice among alternative combinations of formal and informal care depends on the type of living arrangement chosen, and that these living arrangement choices in turn are influenced by the public provision of formal home care. Using data from a social experiment, we find that a generous public home care program significantly increases the probability that unmarried persons will live independently and reduces the probability of living in shared households or in nursing or personal care homes. However, any substitution effects-either direct effects on provision of informal care given living arrangement or indirect effects due to living arrangement changes-appear to be small.
Liliana E. Pezzin is a researcher at the Center for Delivery Systems Research, Agency for Health Care Policy and Research, Rockville, Maryland; Peter Kemper is deputy director, Center for Studying Health System Change; James Reschovsky is a researcher at the Center for Delivery Systems Research, Agency for Health Care Policy and Research. The authors wish to thank Steven Stern, Randall Brown, Barbara Schone, Pamela Short, and two anonymous referees for many insightful comments and suggestions. The views expressed in the paper are those of the authors. No official endorsement by either the Department of Health and Human Services or the Agency for Health Care Policy and Research is intended or should be inferred. The data used in this article can be obtained beginning in November 1996 through October 1999 from Liliana E. Pezzin at AHCPR, 2101 East Jefferson Street. Suite 500, Rockville, MD 20852.
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