Ludovico Carrino: Vulnerability and Long-Term Care in Europe - an economic perspective


Ludovico Carrino, King's College London (United Kingdom)


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This presentation discussed and documented the policy relevance of long-term care (LTC) insurance by offering novel insights as to the institutional arrangements prevailing in Europe. A first crucial step is to describe and measure vulnerability, analyse eligibility conditions and estimate the degree of potential LTC coverage. We provided a detailed taxonomy of the forms of public coverage existing in Austria, Belgium, Czech Republic, England, France, Germany, Italy and Spain, and addressed the substantial differences existing across Europe in the definition of the target population in need-of-LTC due to a reduced degree of physical or cognitive capacity. A striking feature of most public LTC systems is that they are extremely fragmented and show a significant variability of benefits and provisions even at a local level. We documented the efficacy of the different long-term care provisions in different institutional contexts, and simulated 'counterfactual' regimes. In particular, we estimated comparable measures of potential coverage for specific LTC systems, disentangling the population effect from the regulation effect in the different countries. Our applied analysis exploited information from large surveys representative of the European population age 50 and over, such as ELSA (English Longitudinal Study on Ageing) and SHARE (Survey of Health, Ageing and Retirement in Europe). Our work makes two substantial contributions: we estimate the potential coverage rates results from country-specific definitions of vulnerability without imposing a priori criteria; second, we use micro-data to control for the different epidemiologic characteristics of the population in different European countries.

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International seminar
12:30 - 14:00