Who Cares? Four Essays on Elderly Care Markets

Abstract

This doctoral thesis addresses key challenges in elderly care, focusing on care demand and access, care quality, and nursing personnel. The study comprises four chapters, each delving into distinct aspects of the complex landscape of elderly care. In the first chapter, we investigate the impact of provider density in the ambulatory home health care market on care quality. Surprisingly, our findings reveal an inverse relationship, suggesting that higher provider density correlates with lower quality of care. We underscore the crucial role of the nursing workforce in shaping care outcomes. Chapter two scrutinizes management metrics of nursing homes amidst an urgent personnel shortage. Through our analysis, we uncover an escalation process, beginning with the publication of job vacancies, escalating to higher personnel workload, and diminished access and capacity, posing significant challenges to care provision. The third chapter examines the driving factors behind regional variations in demand for German nursing home care. Our research sheds light on why individuals opt for stationary nursing home care, highlighting the constrained availability of informal home care options as a significant factor influencing demand dynamics. In the final chapter, we explore the implications of higher single room standards in nursing homes on access for individuals with severe care needs. Additionally, we assess the effects on the informal home care market when access to nursing home care becomes restricted. Our findings contribute valuable insights to the ongoing discourse on optimizing elderly care systems to meet the evolving needs of aging populations.