Abstract: 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. This presentation aims 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 study used a ‘production-function’ approach with survey data, including (ASCOT-measured) CRQoL, whereby we statistically model 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 English survey data, we found that community-based LTC significantly improved people’s CRQoL but with diminishing marginal effects and effects differentiated by baseline impairment levels. The presentation will discuss how the care system might respond to changes in global public budgets on the basis of the results. 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.

Bio: Julien Forder is Professor of the Economics of Social Policy and Director of PSSRU at the University of Kent. Until recently he was also an Associate Professorial Research Fellow at the London School of Economics. In the past, Julien has been seconded to the King's Fund as project lead for the Wanless social care review and to the Strategy Unit in the Department of Health, providing advice to Ministers on social care and related areas of health policy. He is an economist and has conducted research in social care for many years.

Julien's Google Scholar profile can be accessed here.