The use of long-term care services by the Dutch elderly

The main focus of this paper is the development of an appropriate framework to characterize the process of long-term care utilization by the Dutch eld erly. Three broad categories of care services are considered, namely, infor mal care, formal care at home, and institutional care. The use of these car e alternatives is modelled jointly, and stochastic dependence is allowed be tween the various care options. Special attention is given to the concept o f health status and to the potential endogeneity of this variable in the mo del. We apply a flexible non-parametric method to summarize the multidimens ional concept of health status into a limited set of interpretable indices. The model is applied on the Longitudinal Ageing Study Amsterdam (LASA). We find strong effects of health status, gender, socio-economic variables, an d prices on the utilization of long-term care services. Copyright (C) 2000 John Wiley & Sons, Ltd.