Co-payments in long-term home care: do they affect the use of care?

We study the effect of a policy change in co-payments on the use of long-term home care in The Netherlands. The change increased co-payments for persons with considerable household financial assets. For identification we apply a difference-in-difference analysis with matched treatment and control groups.

We find a significant effect at the extensive margin: persons affected by the policy change are less likely to take up care. The magnitude of the response increases over time, corresponding with an average annual price elasticity of demand of -0.14 and a price elasticity of -0.26 for episodes of care one year after the change. We do not find a significant effect at the intensive margin: persons who take up care do not use less hours of care.