Long-Term Care Models and Dependence Probability Tables by Acuity Level: New Empirical Evidence from Switzerland

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Serval ID
serval:BIB_900A635B6B46
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Long-Term Care Models and Dependence Probability Tables by Acuity Level: New Empirical Evidence from Switzerland
Journal
Insurance: Mathematics and Economics
Author(s)
Fuino M., Wagner J.
ISSN
0167-6687
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
81
Pages
51-70
Language
english
Abstract
Due to the demographic changes and population aging occurring in many countries, the financing of long-term care (LTC) poses a systemic threat. The scarcity of knowledge about the probability of an elderly person needing help with activities of daily living has hindered the development of insurance solutions that complement existing social systems. In this paper, we consider two models: a frailty level model that studies the evolution of a dependent person through mild, moderate and severe dependency states to death and a type of care model that distinguishes between care received at home and care received in an institution. We develop and interpret the expressions for the state- and time-dependent transition probabilities in a semi-Markov framework. Then, we empirically assess these probabilities using a novel longitudinal dataset covering all LTC needs in Switzerland over a 20-year period. As a key result, we are the first to derive dependence probability tables by acuity level, gender and age for the Swiss population. We find that the transition probabilities differ significantly by gender, age and time spent in the frailty level and type of care states.
Keywords
long-term care, semi-Markov model, actuarial dependence tables
Create date
24/05/2018 9:05
Last modification date
16/12/2019 7:19
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