title: Formal and informal care for disabled elderly living in the community: an appraisal of French care composition and costs.
abstract: OBJECTIVE
  Choices between formal and informal care for disabled elderly people living at home are a key component of the long-term care provision issues faced by an ageing population. This paper aims to identify factors associated with the type of care (informal, formal, mixed or no care at all) received by the French disabled elderly and to assess the care's relative costs.
  
  
  METHODS
  This paper uses data from a French survey on disability; the 3,500 respondents of interest lived at home, were aged 60 and over, had severe disability and needed help with activities of daily living. We use a multinomial probit model to determine factors associated with type of care. We also assess the cost of care with the help of the proxy good method.
  
  
  RESULTS
  One-third of disabled elderly people receive no care. Among those who are helped, 55% receive informal, 25% formal, and 20% mixed care. Low socioeconomic status increases difficulties in accessing formal care. The estimated economic value of informal care is 6.6 billion euro [95% CI = 5.9-7.2] and represents about two-thirds of the total cost of care.
  
  
  CONCLUSIONS
  Public policies should pay more attention to inequalities in access to community care. They also should better support informal care, through respite care or workplace accommodations (working hours rescheduling or reduction for instance) not detrimental for the career of working caregivers.
authors.affiliation: INSERM, U912 (SE4S), 23 rue Stanislas Torrents, 13006 Marseille, France. alain.paraponaris@inserm.fr
authors.forename: Alain
authors.initials: A
authors.lastname: Paraponaris
authors.forename: Bérengère
authors.initials: B
authors.lastname: Davin
authors.forename: Pierre
authors.initials: P
authors.lastname: Verger
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D017028:Caregivers / Q000191:economics* / Q000706:statistics & numerical data; D003153:Community Health Services / Q000191:economics*; D016001:Confidence Intervals; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D019538:Health Care Surveys; D006299:Health Services for the Aged / Q000191:economics* / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012959:Socioeconomic Factors