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The impact of long-term care on quality of life

Forder, Julien, Vadean, Florin, Rand, Stacey E. and Malley, Juliette ORCID: 0000-0001-5759-1647 (2018) The impact of long-term care on quality of life. Health Economics, 27 (3). 43 - 58. ISSN 1057-9230

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Identification Number: 10.1002/hec.3612


Long-term care (LTC) services are provided to help people manage the consequences of impairment, but their impact goes beyond the meeting of basic needs. Accordingly, the main aim was to explore the marginal effectiveness of care when measured in terms of people’s overall care-related quality of life (CRQoL) and assess changes in marginal effect for increasing intensity. The associated aim was to refine and apply an observational method to estimate marginal effectiveness. A ‘production-function’ approach was used with survey data, including ASCOT-measured CRQoL, whereby we statistically modelled the expected relationship between service utilisation rates and CRQoL. This method seeks to limit endogeneity issues by controlling on observables and using instrumental variable (IV). Using a survey of publicly-funded long-term care service users in England, we found that community-based LTC significantly improved people’s CRQoL but with diminishing marginal effects and effects differentiated by baseline impairment levels. There are implications for how the care system should respond to changes in global public budgets. For example, where there is unmet need, a system aimed to maximise (unadjusted) CRQoL would put more emphasis on access (more recipients) than intensity of support compared to a system operating on a needs basis.

Item Type: Article
Official URL:
Additional Information: © 2017 The Authors
Divisions: Personal Social Services Research Unit
Subjects: H Social Sciences > HV Social pathology. Social and public welfare. Criminology
R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 07 Nov 2017 15:45
Last Modified: 20 Oct 2021 01:22
Projects: QORU (PRP 100/0001)
Funders: Policy Research Programme

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