Differences in incidence and prevalence in long-term care among the elderly in Germany: the role of education

Olga G. Grigorieva, Max Planck Institute for Demographic Research
Gabriele Doblhammer-Reiter, University of Rostock

As the proportion of the elderly increases, the problem of long-term care (LTC) utilization attracts more and more attention of researchers and policy makers. Individual health status, living and financial arrangements along with available community resources are all expected to have an impact on care use. This paper analyzes the association between educational level and the transition to LTC in Germany using the only available source of data to evaluate this association, the German Micro Census panel data. The sample used for the analysis is restricted to individuals aged 65 years and above. Men and women and western and eastern parts of Germany are studied separately. Panel logit model is applied to assess the impact of explanatory variables on the first use of care while Generalized Estimation Equations (GEE) model takes into consideration the recurrence of the transition. Receiving Care Allowance (‘Pflegegeld’) is considered as a proxy for the LTC utilization. The eligibility to this payment depends on the subjective physical assessment of the applicants. The preliminary results reveal the higher incidence rates for less educated people as well as for women and people residing in East Germany. The logit regression model indicates the significant association between education and the transition to LTC for men and individuals from West Germany only. When recurrent status of the event is taken into consideration (GEE model), education is found to have a very strong impact on the transition to care for both men and women as well as for two regions.