The residential healthcare for the elderly in Italy: some considerations for post-COVID-19 policies

Source avec lien : The European Journal of Health Economics, (En ligne). 10.1007/s10198-021-01388-9

En Italie, la pandémie de COVID-19 et le décès de nombreuses personnes âgées ont mis en évidence la distribution territoriale inégale des maisons de retraite, qui ont amplifié la propagation et la gravité de la pandémie. En appliquant un modèle MCO groupé aux régions italiennes, sur la période 2010-18, nous étudions les facteurs de demande, les forces du marché et les moteurs institutionnels de la distribution spatiale des soins résidentiels pour les personnes âgées

In Italy, the COVID-19 pandemic and the death of many elderly people have put in evidence the uneven territorial distribution of nursing homes, which have amplified the spread and severity of the pandemic. By applying a pooled OLS model to the Italian regions, over the 2010–18 period, we investigate the demand factors, market forces and institutional drivers of the spatial distribution of residential healthcare for the elderly. Using a fine-grained approach that considers specific regional and age-related elements and the market environment, which can reduce or increase the pressure on regional governments to provide formal assistance, we find that the financial resources and the availability of unemployed women as potential caregivers explain the distribution of expenditure better than the health needs of the elderly. As a result, the expenditure is concentrated in richer and more financially autonomous regions and it is not congruent with the distribution of chronicity, health and frailty factors or income among the elderly. These critical issues of the care services for frail elderly people, related to a highly decentralized governance and resulting in fragmented, market-driven provision, could be attacked only by a national reform.

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