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