The increase in the proportion of elderly people in most industrialized countries triggers higher demand for long-term care (LTC) associated with limitations in activities of daily living (ADL). The aim of this research is to derive the drivers affecting the probability of reporting limitations in ADL and the probability of demanding formal LTC, e.g., personal care and services in domestic tasks. By using the most recent wave of a cross-national European survey on individuals aged over 50 years (SHARE, wave 6), we develop econometric models for identifying the effect of demographic, social and medical factors on ADL limitations and formal LTC along five conjectures. On the one hand, we analyze functional limitations and we find that characteristics such as the age, the gender, the wealth status and the education level influence the probability to report limitations. Further, while we find that pathologies significantly increase the probability to become dependent in general, the effect of cancer is lower. On the other hand, we find again an influence of the demographic and social factors on the probability to use formal LTC. We emphasize on the decrease in the probability due to the presence of the partner in the household, in particular for housekeeping tasks. This is less the case for help related with personal care. In addition, we note that pathologies such as cancer have no influence on the probability to report formal LTC while others like mental and Parkinson diseases highly increase it. We find that elderly living in countries with LTC family care schemes report less formal care than in others. This indicates the importance of LTC policies. Finally, we validate the robustness of our results by applying the models to data from earlier waves of the survey. Our findings give insights for the underwriting standards to be used in future LTC insurance products and for the design of LTC policy environments across Europe.

中文翻译：

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报告整个欧洲的ADL限制和正式使用LTC的特征

在大多数工业化国家，老年人比例的增加引发了对长期护理（LTC）的更高需求，这与日常生活活动（ADL）的局限性有关。这项研究的目的是推导影响ADL报告限制的可能性和要求正式LTC（例如家务中的个人护理和服务）的可能性的驱动因素。通过使用欧洲最近一次针对50岁以上人群的跨国调查（SHARE，第6浪），我们建立了计量经济学模型，通过五个猜想来确定人口统计学，社会和医学因素对ADL限制和正式LTC的影响。一方面，我们分析了功能限制，发现诸如年龄，性别，财富状况和受教育程度会影响报告限制的可能性。此外，尽管我们发现病理学通常会显着增加依赖的可能性，但癌症的影响却较低。另一方面，我们再次发现人口和社会因素对使用正式LTC的可能性的影响。我们强调由于家庭中有伴侣的存在而导致发生机率降低的情况，特别是在执行家政任务时。与个人护理有关的帮助很少出现。此外，我们注意到，诸如癌症之类的病理对报告正式LTC的可能性没有影响，而诸如精神疾病和帕金森氏病之类的其他疾病却大大增加了这种情况。我们发现，生活在拥有长期护理家庭计划的国家中的老年人报告的正规护理要少于其他国家。这表明LTC政策的重要性。最后，我们通过将模型应用于早期调查浪潮的数据来验证结果的稳健性。我们的发现为将来的LTC保险产品中使用的承保标准以及整个欧洲的LTC政策环境设计提供了见识。