Public preferences for paying for social care in later life in England: A latent class analysis. (April 2021)

• Record Type: Journal Article
• Authors: Read, Sanna; Erens, Bob; Wittenberg, Raphael; Wistow, Gerald; Dickinson, Francis; Knapp, Martin; Cyhlarova, Eva; Mays, Nicholas
• Is Part Of: Social science & medicine. Volume 274(2021)
• Publication Date: 2021-04
• Subjects: Social care of older people -- Latent class analysis -- Long-term care -- Funding -- Paying for care -- Public attitudes -- England; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2021.113803
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: There is ongoing debate about how the funding system for social care of older people in England should best be reformed. We investigated how public attitudes to individual and state responsibility for paying for social care in later life vary with demographic and socio-economic characteristics. Four vignettes of individuals in need of home care or residential care with varying levels of savings, income and housing wealth were presented to a sample of people aged 18–75 years ( n = 3000) in December 2018. Respondents were asked if care costs should be paid by the user, the state or shared. They were also asked about the best way to pay for social care in old age. Latent class analysis was used to identify sub-groups with similar preferences for paying for care, and to explore their socio-demographic characteristics. We identified five classes. The majority (Class 1, 58%) preferred that the state and the user should share social care costs. Class 2 (18%) thought that the state should pay all costs regardless of users' savings, income or housing wealth. Class 3 (15%) preferred users to pay all costs at all levels of savings, income and housing wealth, with the exception of those unable to afford the costs. Classes 4 and 5 (5% each) were characterised by different patterns of 'don't know' answers. Socio-economic status was higher among those proposing higher user contributions (Class 3) and lower among those with several 'don't' know' responses (Classes 4 and 5). Concerns about care costs in old age were high among those proposing that the state pays all costs (Class 2) and those preferring that users pay all costs (Class 3). This study shows that public views on social care funding vary with respondents' characteristics and that proposals to reform the system need to be carefully calibrated. Highlights: How best to reform England's system for paying for care continues to be debated. Evidence on public attitudes on how to pay for social care in England is limited. Most respondents thought that the costs should be shared between state and user. Preferences varied with people's demographic and socio-economic characteristics. Policy-makers considering reforms should recognise this variation in public views.