older people’s participation in disability benefits: targeting, timing and financial wellbeing...
TRANSCRIPT
Older people’s participation in disability benefits: targeting, timing and financial wellbeing
Francesca ZantomioCa’ Foscari University of Venice
New Directions in Welfare 2011, Paris
MotivationProvision and funding of social care for the elderly, in the light of population ageing
Public provision for older people with disabilities in the UKAttendance Allowance (AA)
Cash additions to means-tested programsLocal Authorities’ provision of care
Are (extra-costs) disability benefits in cash an effective form of support for the elderly?
Research questions
• Targeting: is entry into AA responsive to changes in potential claimants’ disability status ?
• Timing: how long does it take to claim AA, after the onset of disability? Who takes longer to claim AA, after the onset of disability?
• Perceived financial wellbeing: is AA making a difference to recipients?
Attendance AllowanceEligiblity aged 65+
need of care as a consequence of disabilitynon means-tested
Award £300 monthly if need care throughout day and night £200 monthly if need care throughout either day or night
Timing of claim and receipt
Request application packCounts as date of claim if form returned by 6 weeksAdministration takes 24 working days to process claimReceipt starts after the eligibility condition has lasted for
6 months
DataBritish Household Panel Survey data, waves 1-17
Range of health state indicators:
Self reported health statusActivities of Daily Living (ADL)Specific health problemsInformal care receivedRegistered or self-reported disabled Use of health services (GP visits, hospital days, other)Number of serious accidentsInterviewer’s report of physical difficultiesMental distress
Financial resources
Whether has received AA since September of the previous year
Sample selection
• Respondents aged 65+, at risk of AA eligibility
• Exclude cases:In receipt of DLAUnobserved in year prior to first reported receipt of AA
• Endogenous selection?
• Sample size: 5,334 individuals; 1,009 entries into AA (absorbing state)
Targeting: who receives AA?
Targeting: who receives AA?Disability indicator
Targeting: who receives AA?
Timing: gap between disability onset (after 65+) and first AA receipt
Timing: gap between disability onset (after 65+) and first AA receipt
Outcomes after receiptAA meant to support the “extra-costs” of disability: does it make a
difference to recipients’ perceived financial wellbeing?
Exploit the imperfect targeting features of AA (AA award as a “lottery” for observationally equivalent individuals)
Compare the later outcomes of - AA entrants at a given point in time t with those of - observationally equivalent individuals who, despite facing the same risk of AA entry in t, have not entered the program, at least up to t
Assume no unobserved confounding determinant of selection into AA entry in t
Estimate propensity score for entry in AA in t, wave by wave, to build appropriate control group– no replacement– 0.05 caliper
Conclusions Entry into AA is highly responsive to previous changes in
disability status
AA enhances recipients’ perceived financial wellbeing
However
Personal and household characteristics, unrelated to eligibility, do affect the benefit assignment mechanisms, raising horizontal equity concerns
Considerable delays in claiming are also found which, given the low life expectancy of disabled elderly, might severely compromise the effectiveness of the program
Measurement error in AA receipt
0.0
2.0
4.0
6In
re
ceip
t of A
A
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100Age
Uncleaned
0.0
2.0
4.0
6In
re
ceip
t of A
A
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100Age
Cleaned
Disentangle AA and DLA receipt
Estimated probability distribution - delay in receipt of AA
