Optimizing long-term care provision


Long-term care (LTC) expenditures in the Netherlands are among the highest worldwide. They cause concerns about fiscal sustainability which have led to spending growth reductions, e.g. by stimulating informal care and home care instead of nursing home care. Simultaneously, concerns about quality have led to a substantial budget increase for nursing homes. In this climate, knowing where the marginal returns to LTC expenditures are the largest for patients and families is crucial for optimizing LTC policy.
We contribute new evidence about two key issues. First, we investigate the optimal mix of LTC services: can public LTC expenditures be lowered – by substituting home care for nursing home care or by stimulating informal care – without harming patients and caregiving family members? Second, are differences in patient outcomes across nursing homes related to differences in inputs, or merely caused by case-mix differences?
To this end, we (i) Apply and extend novel econometric techniques; (ii) Use unique dministrative data covering the full Dutch population and novel online data on quality of care; iii) Exploit exogenous variation in care use caused by policy reforms and regional differences.
This project will provide insights about how LTC spending may be optimized. This is a severely under-researched topic in economics that can deliver critical information for policymakers in the Netherlands and abroad aiming to meet the care demands of an ageing population while striving to control public expenditures.





Prof. dr. E.K.A. van Doorslaer

Verbonden aan

Erasmus Universiteit Rotterdam, Erasmus MC, Erasmus School of Health Policy & Management ( ESHPM )


01/09/2019 tot 31/08/2023