Original Paper

The European Journal of Health Economics

, Volume 13, Issue 4, pp 461-490

First online:

The trade-off between formal and informal care in Spain

  • Sergi Jiménez-MartínAffiliated withUniversitat Pompeu Fabra, Barcelona GSE and FEDEA Email author 
  • , Cristina Vilaplana PrietoAffiliated withUniversidad de Murcia and FEDEA

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Understanding the factors that determine the type and amount of formal care is important for predicting use in the future and developing long-term policy. In this context, we jointly analyze the provision of care at both the extensive (choice of care) and the intensive margin (number of hours of care received). In particular, we estimate and test, for the first time in this area of research, a sample selection model with the particularities that the first step is a multinomial logit model and the hours of care is an interval variable. Our results support the complementary and task-specific models which evidence has been found in other countries. Furthermore, we obtain evidence of substitution between formal and informal care for the male, young, married and unmarried subsamples. Regarding the hours of care, we find significant biases in predicted hours of care when sample selection is not taken into account. For the whole sample, the average bias is 2.77% for total hours and 3.23% for formal care hours. However, biases can be much larger (up to 10–15%), depending on the subsample and the type of care considered.


Long-term care Formal care Informal care Caregivers

JEL codes

I1 J14