Socioeconomic differences in the prevalence in statutory long-term care among the German elderly

Olga G. Grigorieva, Max Planck Institute for Demographic Research
Gabriele Doblhammer-Reiter, University of Rostock

In a view of recent and future demographic changes, the provision of long-term care for the elderly becomes increasingly challenging. The development of the policies and programs attempting to offer the cost-effective care requires a sufficient amount of information not only on the macro but also on the individual level. Utilizing the German Micro Census data (2005-2009), the paper estimates an impact of socioeconomic (by means of education) and environmental (by means of the size of the district) factors on the prevalence in statutory long-term care (SLTC) among people aged 65 years and above. Marital status is also used in the analysis to approximate the effect of social network and living arrangements on care utilization. The analysis considers individuals living in both private households and institutions. Particular attention is paid to the disparities between sexes and the residents from East/West Germany. Being assigned to one of the three care levels (‘Pflegestufe’) is considered as a proxy for SLTC utilization, the eligibility to which depends on the physical evaluation of the applicants. The logit regression model is applied to study the direction and the strength of the relationship. The preliminary results reveal the strong impact of education on prevalence in care in a way that the highly educated people have lower risk of using the long-term care services. Educational differentials decrease over time among women while they remain unchanged among men. This is contrary to the trend in educational differentials in German mortality. There, recent research has shown an increase in educational differentials over time.