title: Inequity in long-term care use and unmet need: two sides of the same coin.
abstract: We investigate the determinants of several LTC services and unmet need using data from a representative sample of the non-institutionalised disabled population in Spain in 2008. We measure the level of horizontal inequity and compare results using self-reported versus a more objective indicator of unmet needs. Evidence suggests that after controlling for a wide set of need variables, there is not an equitable distribution of use and unmet need of LTC services in Spain; formal services are concentrated among the better-off, while intensive informal care is concentrated among the worst-off. The distribution of unmet needs for LTC services depends on the service considered and on whether we focus on subjective or objective measures. In 2008, only individuals with the highest dependency level had universal coverage. Our results show that inequities in most LTC services and unmet needs among this group either remain or even increase for formal services.
authors.affiliation: Erasmus School of Economics, Erasmus University Rotterdam and Tinbergen Institute, The Netherlands. Electronic address: garciagomez@ese.eur.nl.
authors.forename: Pilar
authors.initials: P
authors.lastname: García-Gómez
authors.affiliation: European Observatory on Health Systems and Policies, LSE Health, UK.
authors.forename: Cristina
authors.initials: C
authors.lastname: Hernández-Quevedo
authors.affiliation: Department of Applied Economics, University of Granada, Granada, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Jiménez-Rubio
authors.affiliation: University of Castilla La Mancha and REDISECC, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Oliva-Moreno
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D013030:Spain; D055815:Young Adult
keywords: Dependency; Disability; Equity in utilisation; Long-term care; Unmet need