Year: 2025
Type: dissertation
Study design: Observational Study
Abstract: Countries worldwide are being confronted with an ageing society, with the share of the oldest old growing particularly fast. While increased life expectancy is cause for celebration, it also brings substantial economic and fiscal pressures, especially due to the rising demand for long-term care and the growing strain on pension systems. To ensure the sustainability of both long-term care and pension systems, it is essential to adapt public policies to address these evolving needs. A critical component of tackling these challenges lies in understanding how individual decisions — ranging from employment choices to the use of long-term care services — are shaped by economic incentives, such as subsidies, non-wage benefits, and alternative care options. My research seeks to address these challenges by examining the key factors driving retirement income and the demand for long-term care services. Specifically, my dissertation focuses on three main areas: First, I conduct a hypothetical choice experiment to investigate how individuals make trade-offs between wage and non-wage benefits when selecting jobs, with a specific focus on the retirement income effects. This provides insights into how individuals' job choice behavior might change when they are reminded of the long-term impact of their wages on retirement income. We find that providing pension information affects job choices, especially among women. As the effect is mainly present for women, improving pension literacy could potentially help reduce the gender pension gap. Second, I analyze the price sensitivity of long-term care patients within the context of the German long-term care insurance system. This includes assessing the effects of subsidization policies for informal, formal, and institutional care, with a particular emphasis on counterfactual scenarios that explore how changes in subsidies for informal care affect demand. Our findings show that subsidies for informal care play a very important role in shaping the demand for long-term care services. Not providing these subsidies leads to welfare losses for patients and higher expenditures for the government. Finally, I evaluate the role of residential respite care in delaying transitions to long-term care facilities, using Belgian administrative data. I examine whether residential respite care can reduce the likelihood of individuals moving to institutionalized care. Our results suggest that residential respite care can play an important role in supporting "ageing in place" initiatives, as it helps delay or even prevent institutionalization. Overall, my work contributes to a better understanding of the economic factors shaping retirement income and long-term care demand, with implications for policies that aim to support sustainable pension systems and effective long-term care provision.
Source: Lirias
Author: Van Damme, Marjolein
Language: English
Subfield: Accounting
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7112395783
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