Home vs. nursing care: Unpacking the impact on health and well-being.

Care; Health outcomes; Nursing homes; Private vs public; Propensity score matching; Humans; Aged; Male; Female; Middle Aged; France; Aged, 80 and over; Propensity Score; Ownership; Nursing Homes/statistics & numerical data; Nursing Homes/standards; Home Care Services/statistics & numerical data; Health Status; Home Care Services; Health (social science); History and Philosophy of Science

Abstract :

[en] In this paper, we present estimates of the effect of different care settings on health and well- being outcomes. We use data from the French CARE Survey, which interviews individuals aged 60 and above, to assess the differential effect of living at home or in a nursing home on mortality, morbidity and well-being indicators. In addition, we differentiate the effect between for-profit and non-profit nursing homes. To do so, we apply a propensity score matching approach that controls for selection on observables by matching people living at home with those living in nursing homes. Our results are threefold. First, we observe a positive effect of being in a nursing home on health outcomes but a negative effect on other well-being indicators such as happiness and nervousness. Second, the ownership status of the nursing home matters and the positive effect is stronger for non-profit and public nursing homes. Third, residents in for-profit nursing homes appear to to be worse off than those in nonprofit institutions. These findings raise important questions for the future organization and the funding of long-term care.

Disciplines :

Special economic topics (health, labor, transportation...)

Author, co-author :

Bassoli, Elena ; ETH Zurich, Switzerland. Electronic address: ebassoli@ethz.ch

Lefebvre, Mathieu ; Université de Liège - ULiège > Ecole de Gestion de l'Université de Liège ; University of Strasbourg, BETA, CNRS, France. Electronic address: mathieu.lefebvre@unistra.fr

Schoenmaeckers, Jérome ; Université de Liège - ULiège > HEC Liège Research > HEC Liège Research: Economic analysis and policy

Language :

English

Title :

Home vs. nursing care: Unpacking the impact on health and well-being.

Alternative titles :

[fr] Soins à domicile ou soins en institution : analyse de l'impact sur la santé et le bien-être.

Publication date :

November 2025

Journal title :

Social Science and Medicine

ISSN :

0277-9536

eISSN :

1873-5347

Publisher :

Elsevier, England

Volume :

385

Pages :

118533

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S0277953625008640?httpAccept=text/xml

Funders :

ANR - French National Research Agency
INSERM - Institut National de la Santé et de la Recherche Médicale
Université de Strasbourg
CNRS - Centre National de la Recherche Scientifique
EC - European Commission

Funding text :

This work of the Interdisciplinary Thematic Institute MAKErS, as part of the ITI 2021\u20132028 program of the University of Strasbourg, CNRS and INSERM, was supported by IdEx Unistra (ANR-10-IDEX-0002), and by SFRI-STRAT'US project (ANR-20-SFRI-0012). Bassoli thanks funding from HI-GEN-SHARE GRA101066047.

Available on ORBi :

since 31 October 2025

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