Abstract
Population aging raises the question of the long-term care (LTC) organization for the dependent elderly. In France, “in home” LTC is promoted to meet both individual and policy (partly cost-related) preferences. However, LTC management is decentralized at a county level inducing variations in the type of LTC supply, partly due to (unequal) local resources. This article aims to identify county variations in living in institution for dependent elderly people (60+) and how much different LTC supply contributes to these variations. We used different data sources to estimate the probability of living in institution versus at when having disabilities (i.e. bathing difficulties): survey EHPA 2015 for population living in institution (n=308,312) and survey VQS 2014 for population living at home (n=161,419). We complemented these sources with data on contextual LTC supply and socioeconomic status (SES) indicators. Multilevel regression models are computed to assess how much of the county variance of institutionalization decreases when controlling for in LTC supply and SES and identify the share of variance explained by the differences in LTC supply and SES. We found that county variation explained 21% of the institutionalization risk: of which 40% is explained by SES contextual differences and 7% by difference in the LTC supply. Further researches are needed to determine whether these differences reflect county’s unequal resources to supply LTC or county’s different preferences.