Health Care Management Science

, Volume 19, Issue 4, pp 326–337 | Cite as

Determinants of received long-term care – Individual responses to regional nursing home provisions

  • Adam PilnyEmail author
  • Magdalena A. Stroka


Existing literature analyzing the choice of received long-term care by frail elderly (65+ years) predominantly focuses on physical and psychological conditions of elderly people as factors that influence the decision for a particular type of care. Until now, however, the regional in-patient long-term care supply has been neglected as influential factor in this decision-making process. In this study, we analyze the determinants of received long-term care in Germany by explicitly taking the regional supply of nursing homes into account. We estimate a multinomial probit model to illustrate this decision-making process. Therefore, within this discrete choice setting we distinguish between all available types of long-term care in Germany, i.e. four different types of formal and informal care provision. We find that the decision for long-term in-patient care is significantly correlated with the regional supply of nursing home beds, while controlling for physical and psychological conditions of the individual.


Informal care Formal care Choice of care Administrative data Nursing home supply Multinomial probit model 



We thank Thomas K. Bauer, Dörte Heger, Ingo Kolodziej, Sandra Schaffner, Ansgar Wübker and three anonymous referees for helpful comments and suggestions. We are grateful to our colleagues from the WINEG for the access to the data of the Techniker Krankenkasse. Financial support by the German Research Foundation (DFG) and the Ruhr Graduate School in Economics is gratefully acknowledged.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Rheinisch-Westfälisches Institut für WirtschaftsforschungEssenGermany
  2. 2.Ruhr Graduate School in EconomicsRuhr-University BochumBochumGermany
  3. 3.Ruhr-University BochumBochumGermany
  4. 4.WINEG - Scientific Institute of TK for Benefit and Efficiency in Health CareHamburgGermany

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