Incentives, Efficiency and Quality of Care in Long Term Care For The Elderly

ProsjektansvarligSverre A. C. Kittelsen
Oppdragsgivers prosjektnr.256570
ProsjektdeltakereKaren Evelyn Hauge
Øystein M. Hernæs
Tor Iversen
Sverre A. C. Kittelsen
Andreas Kotsadam
Snorre Kverndokk
Simen Markussen
Simen Markussen
Eric Nævdal
Torunn Wibe
Henning Øien
Prosjektperiode2016 - 2022

Prosjektbeskrivelse (engelsk)

The project examines how incentives in the organisation of long term care for the elderly affect their mortality, health and quality of life. We will do this by merging individual patient data from various registers, including information on institutional and home based services from Oslo Nursing Home Agency (ONHA), allowing care providers like ONHA to better understand the effect of economic incentives. State of the art statistical methods will be used to identify causal mechanisms.Extraordinarily detailed data, combined with the expertise of care providers, pave the ground for high quality internationally publishable research. Qualitative studies of patient experience complement the statistics.

A study of selection mechanisms in the provision of long term care will examine how economic incentives interact with health and socio-economic variables. Key questions are whether and how (i) care services are provided solely on the basis of needs, (ii) municipal districts as care providers are affected by economic incentives, (iii) care service profiles affect longevity and health and (iv) user fees affect use of care across groups.

A study of nursing home privatization will build on recent transfers of operation to private companies, using longitudinal data of care provision, patients' characteristics and workforce qualifications for Oslo. Identification of quality differences needs a credible research strategy. The assignment system in Oslo enables us to compare outcomes of patients with identical preferences, (in practice) randomly allocated across institutions. Qualitative studies complement the statistical studies to achieve verification and interpretation of results. We will also examine effects of privatization on the workforce as well as productivity.

The role of the regular general practitioners in elderly care will be examined, focusing on the extent to which economic incentives affect care services allocation across space and socioeconomic variable.


Vitenskapelige tidsskrift

Hernæs, Øystein, Snorre Kverndokk, Simen Markussen, Henning ØienKun etter behov? Tilgangen til pleie- og omsorgstjenester og betydningen av helse, familiesituasjon og sosioøkonomisk status2022Tidsskrift for omsorgsforskning Vol 8(1), 1-14[PDF] [DOI]
Kverndokk, S. and H. O. MelbergUsing fees to reduce bed-blocking: A game between hospitals and long-term care providers2021European Journal of Health Economics 22(6), 931-949[PDF] [DOI]

Andre tidsskrift

Iversen, Tor, Sofie Waage Skjeflo, Nina Bruvik Westberg og Henning ØienStatlige ambisjoner og lokale beslutninger i omsorgspolitikken2021Samfunnsøkonomen nr 1, 29-44[PDF]
Iversen, Tor, Henning ØienTilpasning til brukerbetaling for omsorgstjenester2019Samfunnsøkonomen 133(6), 68-77