Abstract

Objectives: Long-term care (LTC) services are provided to help people manage the consequences of impairment, but the impact of these services is on the quality of life of people receiving them. Since most LTC services have de facto effectiveness there is little research exploring their relative performance. The main aim of this study was to explore the marginal effectiveness of care when measured in terms of people’s overall care-related quality of life (CRQoL) and assess changes in marginal effect for increasing intensity in three European countries. The associated aim was to compare marginal effectiveness across the three countries.

Methods: In total, over 1,500 personal standardised interviews were conducted in the three countries. A ‘production-function’ approach was used with cross-sectional survey data. The survey included the ASCOT measure of CRQoL. We statistically modelled the expected relationship between service utilisation rates and CRQoL. The method seeks to limit endogeneity issues by controlling on observables and using instrumental variables (IV). The models were estimated separately in each country and we use a narrative analysis to compare the results.

Results and conclusion: Analysis is ongoing, but we expect to find that the results follow those of the English data in that community-based LTC will significantly improve people’s CRQoL but with diminishing marginal effects and effects differentiated by baseline impairment levels. In the presentation we will reflect on any differences across countries in the relative marginal effectiveness and in any differences between population sub-groups within the countries. We will also reflect on the implications for how care systems should allocate budgets.