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8 September 2022

Trust in the publicly financed care system and willingness to pay for long-term care: A discrete choice experiment in Denmark

Anna Amilon , VIVE: The Danish National Center for Social Research, Denmark

Agnete Aslaug Kjær, Copenhagen Municipality
Jacob Ladenburg, Technical University of Denmark
Anu Sire, Tampere University

Abstract

Aging populations put pressure on the provision and financing of long-term care services in many countries. The projected increase in long-term care expenditures may in particular constitute a threat to the future sustainability of public budgets in welfare states, where long-term care is financed through taxes. To accommodate the increasing number of 80+ year-olds in society, policy-makers and service administrators need a better understanding of care preferences among future older adults: What types of services do older citizens prefer most, and which factors shape their long-term care preferences?

A discrete choice experiment (DCE) was administered to a representative sample of the Danish population aged 54-64 from May to July 2019 (n = 1,154), investigating which factors shape individuals' preferences and willingness-to-pay for their future long-term care.

Our results reveal that respondents are willing to make additional out-of-pocket payments to supplement the care provided for free by the municipality. Willingness-to-pay was highest for services such as receiving help from a regular care team ($129 per month) and an extra shower a week ($116 per month). Moreover, we find heterogeneous care preferences, with three user characteristics associated with higher willingness-to-pay for services: higher education, high wealth, and a low trust in the publicly financed care system.

Our results raise concern that inequalities between relatively more and less resourceful older adults may increase in Scandinavian-type welfare states in the future. Such increasing inequality in service provision may undermine citizens' trust in and support of the publicly financed care system.

Slides


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