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on Economics of Ageing |
| By: | Michele Bertani (Ca’ Foscari University of Venice); Yanjiao Chen (Henan Normal University) |
| Abstract: | This paper comparatively analyzes the long-term care (LTC) systems in China and Italy, two countries experiencing profound demographic shifts with rapidly aging populations. While both nations face the common challenge of providing sustainable and adequate care for an increasing number of older adults, their regulations and policy responses diverge significantly, shaped by distinct socio-economic contexts, welfare regimes, and cultural norms. Italy, representing a Southern European welfare model, has historically relied on a fragmented system characterized by familial support, supplemented by cash-for-care benefits and a significant influx of migrant care workers. In contrast, China is in the process of constructing its LTC system, moving from a tradition of family-based care towards a state-led, multi-pillar framework that includes social insurance experiments, private sector engagement, and the integration of health and social care. This paper examines the evolution of LTC policies in both countries, analyzing the drivers behind their different strategic choices. By contrasting the Italian model of "familism by default" with China's top-down, experimental approach, we highlight the respective strengths and weaknesses of each system. The analysis concludes that while no single model is universally applicable, a cross-national comparison offers valuable insights for policymakers grappling with the global challenge of providing sustainable and equitable long-term care in an aging world. |
| Keywords: | Long-term care, China, Italy, Older adults, Governance, Social policies, Welfare systems |
| JEL: | H51 H53 I18 I38 J14 J18 Z18 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:ven:wpaper:2025:27 |
| By: | Banks, J.; French, E.; McCauley, J. |
| Abstract: | This paper examines the nature of long-term care for older adults with cognitive impairments in England1. Long-term care (LTC), which in England is commonly referred to as adult social care, is care that supports daily activities of living for older and disabled individuals to enhance their quality of life. This includes care services ranging from nursing home stays to home-based assistance with tasks like washing, dressing, and eating. For older people with cognitive impairment, such as dementia for example, there may be additional specialized care and support that is necessary. This paper shows that the high care needs of older individuals is largely attributable to those with cognitive impairments: approximately half of the total care costs of the age 65+ population in England are attributable to the 8.5% of individuals with cognitive limitations. |
| Date: | 2025–07–31 |
| URL: | https://d.repec.org/n?u=RePEc:cam:camdae:2583 |
| By: | Dilger, Alexander |
| Abstract: | Ein flexibler Übergang in den Ruhestand ist möglich und häufig vorteilhaft für die Betroffenen sowie andere, insbesondere wenn deswegen länger gearbeitet wird. Deshalb sollten die Optionen dazu weiter verbessert werden, auch für (potentielle) Arbeitgeber einschließlich des öffentlichen Dienstes. |
| Abstract: | A flexible transition into retirement is possible and often advantageous for those affected as well as others, especially if it means working longer. Therefore, the options for this should be further improved, also for (potential) employers, including the public sector. |
| Keywords: | Flexibilität, Pension, Rente, Renteneintrittsalter, Ruhestand |
| JEL: | H55 J26 J65 K31 M55 P16 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:umiodp:333906 |
| By: | Wang, Wanying; Costa-Font, Joan |
| Abstract: | Access to care among older adults can help identify unmet health needs and increase the use of health care, though in some cases it may substitute some forms of health care. We argue that the balance between these two effects is largely gender dependent: female spouses are more likely to act as informal caregivers and, as a result, are more likely to have neglected their own health needs. To examine this hypothesis, we exploit the variation introduced by Scotland’s Free Personal Care (FPC) programme, a government initiative implemented in 2002 that provides free personal care access to all eligible individuals regardless of their income. Using a Difference-in-Differences (DiD) framework comparing Scotland with the rest of the United Kingdom and a rich longitudinal dataset of men and women aged 65 and over, we first find that FPC significantly increased the uptake of home help services among women, with little change among men. Among women, adult care expansion led to a 3.5–percentage-point rise in inpatient admissions, whereas among men, we find evidence suggesting a modest substitution effect of care for health care. The effects are stronger among older adults who live alone, and those facing socioeconomic disadvantage, or high care needs. |
| Keywords: | social care; health care utilisation; complementary effects; ageing; gender differences; free personal care; Scotland; difference-in-differences |
| JEL: | I18 J14 H75 |
| Date: | 2026–01–31 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:130287 |
| By: | Raquel Andrés (Departament d'Economia i CAEPS, Universitat de Barcelona); Alexandrina Stoyanova (Departament d'Economia, CAEPS, BEAT, Universitat de Barcelona) |
| Abstract: | Europe’s rapidly ageing population poses critical challenges for long-term care (LTC) systems, particularly guaranteeing equitable access. While socio-economic disparities in LTC utilisation are well documented, inequalities in unmet needs—the gap between required and received care—are less studied. Using the 2019 European Health Interview Survey for Spain, we quantify the care gap in hours and classify unmet needs as full, partial, or none. Employing the concentration index, we assess socio-economic inequalities in unmet needs, stratified by eligibility for publicly funded LTC and by limitation severity (number of ADL limitations). We find a pronounced pro-poor concentration of the care gap, disproportionately affecting women, individuals living alone, and the oldest-old. Among individuals below the eligibility threshold, inequality is not statistically significant; however, it becomes substantial among those who are eligible and increases with the severity of limitations. Our decomposition analysis reveals that health status, income, and living arrangement explain most of the observed inequality. Notably, among eligible individuals with more severe ADL limitations, living arrangement emerges as the largest contributor. These results point to the need to reduce inequalities that disproportionally affect those in the bottom socio-economic strata and address disparities through more effective resource allocation and targeted policy interventions. By providing a granular measure of unmet LTC need and its socio-economic determinants, this study contributes to the broader discussion on fairness and efficiency of LTC provision in ageing societies. |
| Keywords: | Long-term care, Care gap, Unmet needs, Inequalities |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:ewp:wpaper:489web |
| By: | Shedrawy, Jad (IHE - The Swedish Institute for Health Economics); Olofsson, Sara (IHE - The Swedish Institute for Health Economics); Persson, Sofie (IHE - The Swedish Institute for Health Economics); Göransson, Carina (School of health and welfare, Halmstad University, Halmstad, Sweden); Lace, Ilze (School of health and welfare, Halmstad University, Halmstad, Sweden); Bay Højsted, Birte (Clinical Research Unit, Department of Ophthalmology, Zealand University); Källstrand, Jeanette (School of health and welfare, Halmstad University, Halmstad, Sweden) |
| Abstract: | Visual impairment is a growing public health challenge in ageing societies. Many older adults live with undetected vision problems that affect daily functioning, safety, and independence. This new report from the IHE investigates the clinical, economic, and quality-of-life consequences of systematic vision screening among adults aged 75 and older in Sweden and Denmark. <p> The study was carried out within the EU-funded Interreg Undetected Visual Impairment project and includes data from primary care, optician settings, and homecare services. <p> Key findings <p> High prevalence of undetected visual impairment was found across all settings. <p> Vision problems were common even among individuals who had checked their eyesight within the past year. <p> A large share of participants were recommended further clinical assessment, and about two-thirds followed these recommendations. <p> Most follow-up treatments involved minor corrective measures, such as new glasses, while a smaller number required medical treatment. <p> Economic perspective <p> The report provides detailed estimates of both direct screening costs and broader societal costs related to visual impairment. <p> The direct cost of screening was estimated at approximately 375–520 SEK per person, depending on setting and staff time. <p> The most expensive screening component was fundus photography. <p> Falls related to visual impairment were uncommon but costly, with an average estimated cost of 92, 800 SEK per fall. <p> Informal care generated additional societal costs, even though most participants remained largely independent. <p> These results highlight how even a small number of preventable injuries or care needs can lead to substantial economic consequences, however the screening programs did not show any impact on the prevalence of falls/injuries. <p> Quality of life <p> Vision-related quality of life was measured using the NEI VFQ-25 and converted into health utility values for economic analysis. <p> Health-related quality of life remained relatively stable over six months, however it decreased for some subgroups. <p> No clear improvements were observed following screening, likely due to: <p> • Short follow-up time <p> • baseline health status <p> • Lack of a control group <p> The study therefore cannot determine whether screening leads to measurable quality-of-life gains. <p> Why this matters <p> Systematic vision screening has the potential to: <p> • Detect problems earlier <p> • Prevent avoidable falls and injuries <p> • Support safe ageing at home <p> • Reduce long-term healthcare and care needs <p> However, the report concludes that larger studies with longer follow-up and control groups are needed to determine whether vision screening is cost-effective. |
| Keywords: | older adults; visual impairment; screening; vision test; Costs and disease burden; Kostnader och sjukdomsbörda; elderly care; synnedsättning; äldre |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:hhs:ihewps:2025_017 |
| By: | Saranya Sree Subramaniam (Faculty of Management, Multimedia University, Cyberjaya, 63100, Selangor, Malaysia Author-2-Name: Chinnasamy Agamudai Nambhi Malarvizhi Author-2-Workplace-Name: Faculty of Management, Multimedia University, Cyberjaya, 63100, Selangor, Malaysia Author-3-Name: Author-3-Workplace-Name: Author-4-Name: Author-4-Workplace-Name: Author-5-Name: Author-5-Workplace-Name: Author-6-Name: Author-6-Workplace-Name: Author-7-Name: Author-7-Workplace-Name: Author-8-Name: Author-8-Workplace-Name:) |
| Abstract: | " Objective - This research aimed to understand the factors influencing the use of Internet of Things (IoT) healthcare solutions by elderly patients with non-communicable diseases (NCDs) in Malaysia, utilising the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) and the Health Belief Model (HBM) as guides for the study. Methodology/Technique - A sample of 30 respondents aged 60 years and older participated in the pilot survey, which was conducted using a structured questionnaire on a Likert-type scale. The data analysis was performed using the Statistical Package for Social Sciences (SPSS) version 28 to conduct descriptive statistics, frequency analyses, and reliability analyses to assess instrument consistency. Findings - Performance impact, trust, and task-technology fit were the most significant drivers of IoT adoption, while social influence and facilitating conditions played a minimal role. The results indicated that age, patients' preferences for tangible health, low benefit-centredness, user-friendliness, and data security, compared to source-based encouragement or infrastructure support. Novelty - The novelty of this study lies in the utilisation of UTAUT2 and HBM guidelines to examine IoT adoption among elderly NCD patients in Malaysia, an area that has been largely understudied in digital health. This study also provided a potential customised application for an IoT healthcare system to aid disease control among the elderly. Type of Paper - Empirical" |
| Keywords: | IoT healthcare, Elderly patients, Non-communicable diseases, Technology adoption, UTAUT2, Health Belief Model. |
| JEL: | O14 O33 |
| Date: | 2025–12–31 |
| URL: | https://d.repec.org/n?u=RePEc:gtr:gatrjs:jmmr352 |
| By: | David Boisclair; Xavier Dufour-Simard; Pierre-Carl Michaud |
| Abstract: | Nous analysons l’effet sur l’épargne dans des véhicules enregistrés – incluant le RVER lui-même – de la Loi sur les régimes volontaires d’épargne-retraite (Loi RVER), adoptée en 2014, et de l’obligation pour les employeurs d’offrir un véhicule d’épargne retraite. Nous utilisons deux stratégies d’identification : une approche en double différence (province x année) et une en triple différence (province x secteur public x année), toutes deux appliquées aux données sur les déclarations fiscales de la Base de données administratives longitudinales (DAL). Nos résultats suggèrent une augmentation graduelle, allant jusqu’à 4 points de pourcentage, de la proportion de contribuables ayant cotisé à un véhicule enregistré en raison de la mise en œuvre de la loi. Nous estimons que le taux d’épargne vers ces véhicules, en pourcentage du salaire, a connu une augmentation allant jusqu’à 0, 6 point de pourcentage. Au net, nous estimons une hausse moyenne de l’épargne enregistrée de 0, 4 point de pourcentage entre 2017 et 2022 des suites de la mise en place de la Loi RVER, hausse qui semble concentrée chez les travailleurs à revenu plus élevé. Nous discutons de pistes d’améliorations possibles dans le but de favoriser l’épargne chez les travailleurs ayant un besoin d’épargner pour la retraite au-delà des régimes publics. |
| Keywords: | épargne, retraite, pensions. |
| JEL: | G51 G53 E21 J32 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:rsi:cjpcha:05 |
| By: | Kikuchi, Tatsuru |
| Abstract: | This paper tests whether demographic aging shocks propagate across Japanese municipalities through spatial and economic network channels. Using quarterly panel data on 4, 547 municipalities from 2018 to 2024, I apply the spatial treatment effect framework from \citet{kikuchi2024dynamical} and \citet{kikuchi2024stochastic}, extended with a Lévy–Brownian process \footnote{A temporal jump-diffusion process combining continuous Brownian motion with Lévy jumps.} to capture discontinuous crisis events alongside continuous evolution. The central finding contradicts conventional assumptions: aging shocks remain strictly localized with zero spillovers despite connected infrastructure and dense networks. Five analyses establish this result. Perturbative decomposition shows 99.82 percent of variation explained by direct effects. Treatment effect estimates (ATT=0.355pp, ATE=0.541pp) exclude spillover components. General equilibrium multipliers of 1.04 indicate minimal amplification. Stochastic uncertainty quantification reveals that while Lévy jumps raise crisis probability from 3 to 12 percent, tail risk remains localized. Temporal trends document increasing regional isolation. The absence of spillovers reflects fundamental isolation: Tokyo concentration, infrastructure decay, service withdrawal, and economic hollowing transform Japan's spatial structure from integrated to fragmented. Regional coordination policies are ineffective; local interventions are sufficient. |
| Keywords: | Population aging, demographic spillovers, regional isolation, spatial econometrics, Levy processes, Japan |
| JEL: | C14 C21 C31 C51 J11 R23 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:pra:mprapa:126742 |
| By: | Elif Tasar; John Voorheis |
| Abstract: | We are the first to study how inheritances affect labor supply in the U.S. using large-scale administrative data. Leveraging federal tax and Social Security records, we estimate event studies around parental death to investigate impacts on adult children. Our results indicate that the death of a last parent causes sizable gains in investment income—our main proxy for inheritances—and proportionate reductions in labor supply. On average, annual per-adult investment income at the tax unit level increases by about $300 (45 percent) and annual per-adult wage earnings decrease by $600 (2 percent). These earnings responses are large relative to the implied wealth transfer. Income effects are the dominant channel through which parental death reduces earnings, with children of wealthier parents exhibiting larger earnings reductions. Over six years, inheritances slightly equalize the distribution of investment income. |
| Keywords: | labor supply, inheritance, aging, household finance, wealth inequality |
| JEL: | J22 D64 D31 |
| Date: | 2025–12 |
| URL: | https://d.repec.org/n?u=RePEc:cen:wpaper:25-71 |
| By: | Carlos Andrés Brando (Universidad de los Andes) |
| Abstract: | This paper identifies Bogotá as a demographic sink during the late nineteenth and early twentieth centuries. The almost permanent contraction of its natural population resulted from low birth rates and heightened death rates. After the Thousand Days’ War (1899–1902), this condition was reversed. Rapid population growth ensued for over a century, as the city added, to the regular flows of immigrants, annual surpluses of its own natural population. Bogotá thus turned into a demographic source. This historical shift from sink to source was closely linked to changes in health. This research demonstrates that three traits of the early health transition (EHT) were present during this transformation: death-rate stabilization, improvements in life expectancy, and structural changes in the causes of death. It reconstructs historical statistics for crude death, birth, marriage, and natural-increase rates, and develops life tables, including survival rates based on abridged and period data from largely unpublished or unexplored archival sources. These empirical findings substantiate the contributions made to the literature on the city’s social and demographic past and broaden the perspectives for other scholars to apply the EHT and naturalpopulation frameworks to the historical evolution of cities in Latin America and beyond. |
| Keywords: | historical demography, health transition, life expectancy, mortality, fertility, Bogota |
| JEL: | I12 J11 J13 N36 |
| Date: | 2025–12 |
| URL: | https://d.repec.org/n?u=RePEc:col:000089:021850 |