Special Issue "The Economics of Caring"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: 15 September 2021.

Special Issue Editors

Prof. Dr. Pablo Moya Martinez
Website
Guest Editor
Department of Economic Analysis and Finance, Universidad de Castilla-La Mancha, Cuenca, Spain
Interests: care financing; health care cost; long-term care cost; long-term care financing; chronic diseases
Prof. Dr. Raúl del Pozo Rubio
Website
Guest Editor
Department of Economic Analysis and Finance, Universidad de Castilla-La Mancha, Cuenca, Spain
Interests: care financing; health care cost; long-term care cost; long-term care financing; chronic diseases

Special Issue Information

Dear Colleagues,

We are currently organising a Special Issue entitled “The Economics of Caring” in the International Journal of Environmental Research and Public Health. IJERPH is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph.

From the very beginning of the lives of human beings, care is an essential and unavoidable activity. This task conditions the behaviour and roles assigned to each household member and the knowledge, training, and responsibility that accompany those roles. In this sense, caring transcends not only the action of providing help or attention to the caregiver, but also restricts the development of another potential activity of the caregiver (for example, employment, training, leisure, etc.). The sociodemographic changes we are experiencing and the facts discussed above have pushed states into rethinking the social protection systems that must be offered, raising questions about what kind of protection to give, who should give it (unpaid care work or paid care work), and how it should be provided. Finally, all this has an impact on the micro-, meso-, and macroeconomic spheres of families and, therefore, on the economic structure and well-being of each society.

Now we are in the year 2020, which represents the closure of a decade of profound revolutions in economic, financial, and political thinking derived from the subprime crisis among many other factors, accompanied by other equal or more intense riots in the social field, where family structures and social and health services have been questioned in terms of efficiency, equity, and extension or reduction of social rights. Therefore, within this context, analysis and evaluation of the tasks of caring for people with disabilities or dependency, caring for the elderly, or caring for people with diseases becomes a challenge for researchers in health economics. Allowing the economic impact of different casuistic trends that are involved in care to be made visible is necessary to be able to give the political decision-maker valuable, relevant, and complete information for the decision-making process and thus be able to design efficient actions that converge with the needs demanded by societies.

Finally, it is essential to mention that the economics of caring has been an increasing topic of interest in the last two decades. We should note that in submitting a query in PubMed with the text “economics” or “economic” and “caring” or “care” in the title or abstract of the indexed articles, we find that there is a significant increase in these works during the last decade of approximately 8.5% per year, reaching the figure of 3962 articles for the year 2019. Therefore, it is now an excellent time to provide, in a monograph, a global perspective of the subject, with an overview of the most-affected countries and of the latest methodological advances. In addition, other issues of interest will be addressed, including the following:

International perspectives of the economics of caring;

Specific studies for illness or particular population segments involved in care, including all kinds of costs (direct costs, e.g., healthcare costs; indirect costs, e.g., productivity losses; and intangible costs);

Methods for measuring the effects of care on health and equity, and for evaluating the impact of policies to address the need for care;

Impact of caring on the health of the caregivers;

Present and future trends of informal care: continuation and survival or extinction?

Informal and formal care: complementary or substitutive?

We welcome the submission of reviews, original research articles, short communications, case studies, and other kinds of articles targeting any of these core research questions and beyond. We would be delighted to attract as many diverse submissions representing different geographies and jurisdictions as possible.

Prof. Pablo Moya Martinez
Prof. Raúl del Pozo Rubio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • equity of care social protection the economics of care cost of formal care cost of Informal care caregiver costs care Models costs of care financing of care care changes/care challenges economics of ageing economics of child care economics of Infant care care planning care in illness terminal care palliative care critical care care of illness prevention

Published Papers (8 papers)

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Research

Open AccessArticle
The Effect of Changes in Cost Sharing on the Consumption of Prescription and over-the-Counter Medicines in Catalonia
Int. J. Environ. Res. Public Health 2021, 18(5), 2562; https://doi.org/10.3390/ijerph18052562 - 04 Mar 2021
Abstract
Many universal health care systems have increased the share of the price of medicines paid by the patient to reduce the cost pressure faced after the Great Recession. This paper assesses the impact of cost-sharing changes on the propensity to consume prescription and [...] Read more.
Many universal health care systems have increased the share of the price of medicines paid by the patient to reduce the cost pressure faced after the Great Recession. This paper assesses the impact of cost-sharing changes on the propensity to consume prescription and over-the-counter medicines in Catalonia, a Spanish autonomous community, affected by three new cost-sharing policies implemented in 2012. We applied a quasi-experimental difference-in-difference method using data from 2010 to 2014. These reforms were heterogeneous across different groups of individuals, so we define three intervention groups: (i) middle-income working population—co-insurance rate changed from 40% to 50%; (ii) low/middle-income pensioners—from free full coverage to 10% co-insurance rate; (iii) unemployed individuals without benefits—from 40% co-insurance rate to free full coverage. Our control group was the low-income working population whose co-insurance rate remained unchanged. We estimated the effects on the overall population as well as on the group with long-term care needs. We evaluated the effect of these changes on the propensity to consume prescription or over-the-counter medicines, and explored the heterogeneity effects across seven therapeutic groups of prescription medicines. Our findings showed that, on average, these changes did not significantly change the propensity to consume prescription or over-the-counter medicines. Nonetheless, we observed that the propensity to consume prescription medicines for mental disorders significantly increased among unemployed without benefits, while the consumption of prescribed mental disorders medicines for low/middle-income pensioners with long-term care needs decreased after becoming no longer free. We conclude that the propensity to consume medicines was not affected by the new cost-sharing policies, except for mental disorders. However, our results do not preclude potential changes in the quantity of medicines individuals consume. Full article
(This article belongs to the Special Issue The Economics of Caring)
Open AccessArticle
Socioeconomic Factors Related to Job Satisfaction among Formal Care Workers in Nursing Homes for Older Dependent Adults
Int. J. Environ. Res. Public Health 2021, 18(4), 2152; https://doi.org/10.3390/ijerph18042152 - 23 Feb 2021
Viewed by 275
Abstract
Population ageing is increasing the demand for dependent care. Aged care nursing homes are facilities that provide formal care for dependent older persons. Determining the level of job satisfaction among workers in nursing homes and the associated factors is key to enhancing their [...] Read more.
Population ageing is increasing the demand for dependent care. Aged care nursing homes are facilities that provide formal care for dependent older persons. Determining the level of job satisfaction among workers in nursing homes and the associated factors is key to enhancing their well-being and the quality of care. A cross-sectional survey was administered online to nursing home workers (n = 256) in an inland region of Spain over the period from February to May 2017. The questionnaire collected data on sociodemographic variables and others related to training and job satisfaction. The results show that most of the care is delivered by women with a medium level of education. A total of 68% of workers had received formal training, although a significant percentage (65%) thought this was not useful. The highest level of satisfaction was found to be related to users and co-workers. Our factor analysis revealed that the satisfaction components are decision-making, working conditions—e.g., schedule—and the work environment—e.g., relationship with coworkers—. Length of service and working with highly dependent persons are negatively associated with these components. Working in social health care is negatively related to decision-making and working conditions. Training, in contrast, is positively associated with these components. Care is a job that requires appropriate training and preparation to provide quality assistance and to guarantee workers’ well-being. Full article
(This article belongs to the Special Issue The Economics of Caring)
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Open AccessArticle
Quality of Life, Health and the Great Recession in Spain: Why Older People Matter?
Int. J. Environ. Res. Public Health 2021, 18(4), 2028; https://doi.org/10.3390/ijerph18042028 - 19 Feb 2021
Viewed by 310
Abstract
The financial crisis of 2008 precipitated the “Great Recession”. In this scenario, we took Spain as a country of study, because although it experienced significant negative shocks associated with macroeconomic variables (GDP or unemployment), its welfare indicators have been marked by limited changes. [...] Read more.
The financial crisis of 2008 precipitated the “Great Recession”. In this scenario, we took Spain as a country of study, because although it experienced significant negative shocks associated with macroeconomic variables (GDP or unemployment), its welfare indicators have been marked by limited changes. This study used data from waves 2 and 4 (years 2006–2007 and 2010–2012, respectively) of the Survey on Health, Aging and Retirement in Europe (SHARE). Specifically, through logistic regressions we have analysed the effects of socioeconomic, demographic, health and “Great Recession” factors on the quality of life (QoL) of elders in Spain. Although QoL did not change too much during the “Great Recession”, the results confirmed the importance of several factors (such as chronicity) that affect the satisfaction with the QoL among the older people. In this regard, statistically significant effects were obtained for individual exposure to recession. Therefore, a decrease in household income in the crisis period with respect to the pre-crisis period would increase by 44% the probability of reporting a low QoL (OR = 1.44; 95% CI: 1.00–2.07). Furthermore, gender differences were observed. Health and socioeconomic variables are the most significant when determining individual QoL. Therefore, when creating policies, establishing multidisciplinary collaborations is essential. Full article
(This article belongs to the Special Issue The Economics of Caring)
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Open AccessArticle
Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain
Int. J. Environ. Res. Public Health 2021, 18(3), 932; https://doi.org/10.3390/ijerph18030932 - 21 Jan 2021
Viewed by 665
Abstract
Background. The financial effect of households’ out-of-pocket payments (OOP) on access and use of health systems has been extensively studied in the literature, especially in emerging or developing countries. However, it has been the subject of little research in European countries, and is [...] Read more.
Background. The financial effect of households’ out-of-pocket payments (OOP) on access and use of health systems has been extensively studied in the literature, especially in emerging or developing countries. However, it has been the subject of little research in European countries, and is almost nonexistent after the financial crisis of 2008. The aim of the work is to analyze the incidence and intensity of financial catastrophism derived from Spanish households’ out-of-pocket payments associated with health care during the period 2008–2015. Methods. The Household Budget Survey was used and catastrophic measures were estimated, classifying the households into those above the threshold of catastrophe versus below. Three ordered logistic regression models and margins effects were estimated. Results. The results reveal that, in 2008, 4.42% of Spanish households dedicated more than 40% of their income to financing out-of-pocket payments in health, with an average annual gap of EUR 259.84 (DE: EUR 2431.55), which in overall terms amounts to EUR 3939.44 million (0.36% of GDP). Conclusion. The findings of this study reveal the existence of catastrophic households resulting from OOP payments associated with health care in Spain and the need to design financial protection policies against the financial risk derived from facing these types of costs. Full article
(This article belongs to the Special Issue The Economics of Caring)
Open AccessArticle
The Burden of Spinal Muscular Atrophy on Informal Caregivers
Int. J. Environ. Res. Public Health 2020, 17(23), 8989; https://doi.org/10.3390/ijerph17238989 - 02 Dec 2020
Viewed by 710
Abstract
Spinal muscular atrophy (SMA) is one of the most common severe hereditary diseases of infancy and early childhood. The progression of this illness causes a high degree of disability; hence, a significant burden is experienced by individuals with this disease and their families. [...] Read more.
Spinal muscular atrophy (SMA) is one of the most common severe hereditary diseases of infancy and early childhood. The progression of this illness causes a high degree of disability; hence, a significant burden is experienced by individuals with this disease and their families. We analyzed the time taken to care for patients suffering from SMA in European countries and the burden on their informal caregivers. We designed a cross-sectional study recording data from France, Germany, Spain and the United Kingdom. The primary caregivers completed a self-administered questionnaire that included questions about the time of care, The Zarit Burden Interview, type of SMA and socio-demographic characteristics. Multivariate analyses were used to study the associations between the type of SMA, time of care and burden supported by informal caregivers. The caregivers provided 10.0 h (SD = 6.7) per day of care (the principal caregivers provided 6.9 h, SD = 4.6). The informal caregivers of patients with type I SMA had a 36.3 point higher likelihood (p < 0.05) of providing more than 10 h of care per day in comparison with caregivers of patients with type III SMA. The severity of the disease was associated with more time of care and a higher burden on the caregivers. Full article
(This article belongs to the Special Issue The Economics of Caring)
Open AccessArticle
Visualizing Inequality in Health and Socioeconomic Wellbeing in the EU: Findings from the SHARE Survey
Int. J. Environ. Res. Public Health 2020, 17(21), 7747; https://doi.org/10.3390/ijerph17217747 - 23 Oct 2020
Viewed by 508
Abstract
The main objective of this paper is to visualize profiles of older Europeans to better understand differing levels of dependency across Europe. Data comes from wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE), carried out in 18 countries [...] Read more.
The main objective of this paper is to visualize profiles of older Europeans to better understand differing levels of dependency across Europe. Data comes from wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE), carried out in 18 countries and representing over 124 million aged individuals in Europe. Using the information of around 30 mixed-type variables, we design four composite indices of wellbeing for each respondent: self-perception of health, physical health and nutrition, mental agility, and level of dependency. Next, by implementing the k-prototypes clustering algorithm, profiles are created by combining those indices with a collection of socio-economic and demographic variables about the respondents. Five profiles are established that segment the dataset into the least to the most individuals at risk of health and socio-economic wellbeing. The methodology we propose is wide enough to be extended to other surveys or disciplines. Full article
(This article belongs to the Special Issue The Economics of Caring)
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Open AccessArticle
Assessing the Distribution of Elderly Requiring Care: A Case Study on the Residents in Barcelona and the Impact of COVID-19
Int. J. Environ. Res. Public Health 2020, 17(20), 7486; https://doi.org/10.3390/ijerph17207486 - 15 Oct 2020
Viewed by 672
Abstract
In this work, we establish a methodological framework to analyze the care demand for elderly citizens in any area with a large proportion of elderly population, and to find connections to the cumulative incidence of COVID-19. Thanks to this analysis, it is possible [...] Read more.
In this work, we establish a methodological framework to analyze the care demand for elderly citizens in any area with a large proportion of elderly population, and to find connections to the cumulative incidence of COVID-19. Thanks to this analysis, it is possible to detect deficiencies in the public elderly care system, identify the most disadvantaged areas in this sense, and reveal convenient information to improve the system. The methods used in each step of the framework belong to data analytics: choropleth maps, clustering analysis, principal component analysis, or linear regression. We applied this methodology to Barcelona to analyze the distribution of the demand for elderly care services. Thus, we obtained a deeper understanding of how the demand for elderly care is dispersed throughout the city. Considering the characteristics that were likely to impact the demand for homecare in the neighborhoods, we clearly identified five groups of neighborhoods with different profiles and needs. Additionally, we found that the number of cases in each neighborhood was more correlated to the number of elderly people in the neighborhood than it was to the number of beds in assisted living or day care facilities in the neighborhood, despite the negative impact of COVID-19 cases on the reputation of this kind of center. Full article
(This article belongs to the Special Issue The Economics of Caring)
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Open AccessArticle
The Impact of Internet Usage and Knowledge-Intensive Activities on Households’ Healthcare Expenditures
Int. J. Environ. Res. Public Health 2020, 17(12), 4470; https://doi.org/10.3390/ijerph17124470 - 22 Jun 2020
Cited by 1 | Viewed by 608
Abstract
This paper examines the impact of the internet usage and knowledge intensive activities on households’ healthcare expenditures Similarly, the paper aims to recognize and understand, from a value-creation perspective, the correlation between: internet access of households (IA), individuals frequently using the internet (IU), [...] Read more.
This paper examines the impact of the internet usage and knowledge intensive activities on households’ healthcare expenditures Similarly, the paper aims to recognize and understand, from a value-creation perspective, the correlation between: internet access of households (IA), individuals frequently using the internet (IU), individuals searching on internet for health-related information (HI), payments made by households for healthcare (PHH), expressed as euro per inhabitant and employment in knowledge-intensive activities (KIA). The approach utilized in the present study consists of two steps. First, a theoretical framework was conducted to determine the existing relationship between major variables. Next, the Vector Autoregressive (VAR) approach was applied in a case study at European level to prove the three hypothesis we consider. By analyzing the connection between the major variables, a positive and long- lasting impulse response function was revealed, followed by an ascending trend. This suggests that a self-multiplying effect is being generated; and it reasonable to assume that the more individuals use the Internet, the more electronic acquisitions occur. We can thus reasonably conclude that the improvement of the internet usage and knowledge intensive activities on households’ healthcare expenditures process is strongly dependent on people’s capability. Improving IU and KIA is the new reading key in the decision-making process in health system approach. Full article
(This article belongs to the Special Issue The Economics of Caring)
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