Impact du reste à charge sur le volume d'heures d'aide à domicile utilisé par les bénéficiaires de l'APA
Contributor(s)Bureau d'Economie Théorique et Appliquée (BETA) ; Université de Strasbourg (UNISTRA) - Université de Lorraine (UL) - Centre National de la Recherche Scientifique (CNRS)
Centre d'économie de la Sorbonne (CES) ; Université Panthéon-Sorbonne (UP1) - Centre National de la Recherche Scientifique (CNRS)
Centre Maurice Halbwachs (CMH) ; Université de Caen Normandie (UNICAEN) ; Normandie Université (NU) - Normandie Université (NU) - École normale supérieure - Paris (ENS Paris) - École des hautes études en sciences sociales (EHESS) - Centre National de la Recherche Scientifique (CNRS)
soins de long terme
JEL : D - Microeconomics/D.D1 - Household Behavior and Family Economics/D.D1.D12 - Consumer Economics: Empirical Analysis
JEL : I - Health, Education, and Welfare/I.I1 - Health/I.I1.I18 - Government Policy • Regulation • Public Health
JEL : H - Public Economics/H.H4 - Publicly Provided Goods/H.H4.H42 - Publicly Provided Private Goods
JEL : H - Public Economics/H.H7 - State and Local Government • Intergovernmental Relations/H.H7.H71 - State and Local Taxation, Subsidies, and Revenue
[SHS.ECO] Humanities and Social Sciences/Economies and finances
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AbstractURL des Documents de travail : http://centredeconomiesorbonne.univ-paris1.fr/documents-de-travail-du-ces/
Documents de travail du Centre d'Economie de la Sorbonne 2014.24 - ISSN : 1955-611X
Depuis 2001, en France, les personnes âgées dépendantes bénéficient d'une subvention publique (l'allocation personnalisée d'autonomie) pour financer l'achat d'heures d'aide à la réalisation des activités de la vie quotidienne. Cette subvention n'est que partielle et laisse à la charge des bénéficiaires un montant horaire qui varie selon plusieurs paramètres (son revenu, le prix facturé par le prestataire, les tarifs de solvabilisation fixées par l'autorité publique locale). A partir de données administratives issues d'un département, et en tenant compte des règles institutionnelles nationales et départementales, nous estimons l'élasticité de la demande à ce reste à charge, pour l'aide professionnelle à domicile fournie par des prestataires autorisés. Nous montrons que le reste à charge supporté par les personnes âgées dépendantes bénéficiaires de l'APA a bien un impact négatif sur leur consommation d'heures d'aide à domicile. Une augmentation du prix facturé de 10% induit une baisse du volume d'heures de 5.5%, soir 73 minutes pour l'allocataire qui utiliserait 22 heures d'aides, le volume moyen utilisé par les allocataires supportant un ticket modérateur non nul.
In France, since 2001, home care for disabled elderly can be partially subsidized by a public allowance (allocation personnalisée d'autonomie - APA). For eligible elderly people, the amount to be paid for one hour of formal home care depends on their income, according to a national rule, but also on the rate charged by the chosen provider, and the type of provider, according to parameters fixed by local authorities. This specific institutional frame allows us to estimate the price- and income elasticity of the demand for formal home care by disabled elderly, using administrative data, collected in a local district in October 2010, on 11 040 APA beneficiaries and 13 providers. Our estimation results show that, in this district and for regulated long-term care providers, the price-elasticity of demand is slightly negative. An increase of the price charged by the provider by 10% induces a reduction of the number of care hours by 5.5%.
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