Abstract

Context: Informal caregivers are at the core of the care provided to disabled people who live in the community. This paper is aimed at giving quantitative estimates and qualitative evidence for the monetary value of informal care delivered to French elderly using contingent-valuation methods (CVM).

Methods: Data are from a representative population survey of informal caregivers (HSA survey) carried out in 2008 by the French Institute of Statistics and Economic Studies (INSEE). 4,546 persons were asked, among others, about the maximum amount that they would be willing to pay in order to be replaced for one hour of care in a week. The meanvalue for the willingness-to-pay (WTP) was €14.16 (€17.31 if zero-values were excluded). Because of a large part of protest values (53%), we first estimated the probability to give a null or positive value for WTP with a probit model, and second we used OLS to estimate the log-transformed WTP conditionally to the first step. Complementary to the HSA survey, we carried out a qualitative survey (mean duration: 42 minutes) about 27 informal caregivers aimed at assessing the intelligibility of the survey.

Results: The younger and the closer to the care recipient caregivers were, the higher the probability to give a positive or a null value for WTP was. Being a male caregiver, living together as a couple, being in the labor force (compared to inactive) all increased the WTP, respectively by 9%, 33% and 42%. Reporting a good health status, being home owner or having a portfolio also raised the declared WTP by 25%, 14% and 16% respectively. The WTP for one weekly hour of care was decreased by 23% for caregivers who were aged 65 years and older (compared to those aged less than 50), by 35% for respondents with a level of education less than secondary school (15% with a level equal to secondary school, compared to respondent with a level of education higher than secondary school), by 20% for caregivers with an individual disposable income less than €900 per month (compared to caregivers with more than €1,800) and by 13% for respondents who declared to give 3 hours of care per week and more (compared to those who give less than 3 hours).

Conclusion: Poor to moderate answer rates usually weaken the results of CVM used to assess the monetary value of informal care. In this respect, qualitative surveys enabled to divide protest respondents into caregivers who reported that they were not able to pay for something they were used to give, referring to family duty, the ones who found that paying for (only) one hour of care was not convenient and last those who pointed out that care was not a homogeneous good, which content had to be more precise. Caregivers who gave a value mainly based their answer on what they considered as the market value of one hour of care and, for those who participated in the labor force, it tended to the opportunity cost of one hour of their work.

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