Norman Bannenberg (University Duisburg-Essen)

Countries are struggling with the consequences of an ageing population in terms of increased demand for long-term care services. An important policy issue is to create a composition of services that restrains resource use without impacting negatively on health and well-being for the elderly. In this respect, to prevent or at least to delay nursing home admissions is crucial. Preventive home visits (PHV) are types of programs that have been introduced in several countries in different varieties. The purpose is to support autonomy and independence as well as preventing disability and nursing home admissions. Older people are visited by a nurse to assess the various aspects of their health condition followed by initiation of preventive measures. Previous studies show somewhat conflicting results regarding the effects of PHV on disability and composition of care services. This study contributes to the literature by exploiting a natural experiment that covers all Norwegian municipalities. Hence, the study is population-based and follows subjects over a long time period, which is important since both since public health interventions may not show immediate effect and also, the effect may decline over time. We predict that PHV will increase the use of home-based services and reduce the number of nursing home residents. The design allows for applying a difference-in-differences approach to study potentially causal effects of the PHV. Results indicate that the introduction of a PHV program leads to an increase in the use of home-based care of about 5 percentage points and a reduction of the share of people in nursing homes of about 3.5 percentage points. Several robustness checks support the findings. An important follow-up would be to study the implications in terms of social costs and older people’s physical and mental health conditions.