F ก F ก 1 Demand for Long-term Care Services of the ... - ThaiJo

(1)

ก ก

¹

Demand for Long-term Care Services of the Elderly in Bangkok Metropolitan

# $ ²

#% ³ &&$ '(%) ⁴

ก ก!"# $ ก!" %&'!(!)&ก* &(!# )+($&(!##,กก ,-.'!(! /! )0)ก* ก/1ก- 2()+(&(!#) 2(

'!(!1&) )+(ก!"#, %,)( )+(

% "# )+($"# Ordered Logit '#ก/1ก-0 #"#

0 + ,*1*&'!(! ,*1*&0 )ก'#ก '# &ก!"# < '!(! ,*1*! '!(!

)0 =ก"#'!(!) ก02 ! )00/! )&&

0 &#=ก ">((ก)+(ก!"#, % ก*

/-?กก= '# (ก)+(ก 0 2(&'!(!"#2(0กก

* ">()ก#0ก )+(กก&1 " ( '#+# <

@*ก,2("ก ก('!(!"#ก/! !"#'!(! ("#ก!"#

1 $ 1&>ก Bกก#ก!"#&'!(!)&ก*C D12(>กกก(&,* (.) ' !#H"#*I '!(!2 (.'.) '!(& &"&. Dr.Chantal Herberholz "#'!(.I&(=)

2 ./ . " / ./-?/ T#ก.# ก+

3 ./*H " '!(+ / .*#/ T#ก.#

4 ,,. 0WHX ก>ก

(2)

'!(!@*)+ #ก#) +>&ก/1ก- 2 '!(

ก &(> + ก* '#ก)(กก!"#'!(!

("#)*ก&1*0 (ก *&1)0กก

# +ก"#0 ) "# ,ก+"#ก2 "

ก2)(&( ก!"# .,* >@* ก '!(!"#

'!(!"#ก!"#'!(!@*)+ #ก#

: '!(! ก!"# '!(!"# ก!"# ( ก!"#)

Abstract

The objective of this paper is to investigate the factors affecting various types of demand for formal long-term care (hereafter, LTC) services of the elderly in Bangkok Metropolitan Area using primary data and an ordered logit model. We proposed expenditures per type of long-term care service and inter alia asked interviewees about their intention to utilize such services. The results confirm that individual and household factors, i.e. level of ADLs, dependency ratio of the household and the householdls ability to produce care services significantly affect the demand for all types of LTC services. Economic factors, i.e. income of the elderly and household income positively affect the demand for most types of LTC services, while only demand for formal caregivers and day care services is negatively and significantly affected by own price. The results are interpreted to mean that the Bangkok Metropolitan Administration should promote the establishment of public, for-profit and non-profit, long-term care service providers to be able to respond to the increase in future demand in light of demographic change in Bangkok..

Key words : the Elderly, Long-term Care Services, Caregiver, Home Care, Institutional Care

1. !

2)ก#!ก(

กก# "#+ก< ก ก.+ก&ก.

กก*I/-?ก"#" +#

* +ก*20%"

)ก* ## +ก

*&121 70.65 #()t*./.2568 ก+ก##$

(3)

. 70.62 #()t*./. 2573 (

>(+ก&/2ก= ">(

ก# "#! '!(! &(&(

=2(+ &+ก!ก 60 t ก#*&1 =$(# 25.12 ) t*./. 2573 &. )t ก &

+กก 14 t ">(##

#0.(# 15.3 +กก#

"0+กก# 15-59 t

*20%1t*./. 2560 "# %

##."# #ก&ก

# "#>(+กก#

กก*&1&@# ก (# 21ก*&1&'!(2 "

'!(!2 ก/! ก " ,)(ก# "#

+กก# ก&(!#+

2("ก ก+ก'!(!)/2

>ก" + ' * '!(! ! #*)0 ">(!&1 ก# 0)t*./. 2537 . (# 3.6 &'!(!

ก# %*$(# 6.3 "# (# 7.7 )t*./. 2545 "#*./. 2550 &. กก ก)+ ก *( '!(!

">($>0ก&1 2 $>

>#! > 0*

*Wก- กกt*./. 2550 "(*

(# 88.0 &'!(!!"#

)กก2( " '!(!

#0 <)ก!"# > . (# 1.1 2 '!(!"#" (ก"#(# 10.9 '!(!"# D1 )< $+ก)0

ก# 0 ก 11&'!(! '!(!"#

'!(!"#$<(# 40.5 #0!

(# 28.0 + (# 12.0% "#

&0),((# 6.9% " 0(

,ก. ,<*H

##0% xH2( ก!"#

'!(! 2 $ก0ก!"#'!(!

> &(กก&1 ,

&#!ก#*&10ก* ( + #0ก)ก!"#* " &

(# '!(!2 #!ก#!"#*

2(" 0" " 2 2 ก

#กก# ก!"#'!(! $ ก>@* ก!"#0 long-term care $"#

<&1#ก# ' &

2! $'!(!

ก!"#1กก $ก"#2 $ก 0

*0"(ก*0? + )(

# !< 00)(ก ( &,*"#$!

2( 0&

Department of Health and Human &?- ก2()(2( ก!"#

1 กก(&,*"#

ก"*0'!(! ,**#,*0 ,=y0 (กก!"# กก

$0ก=2( ก )(ก ( ++0# % ((ก //*I *+; 2549) ,**#

,*)'!(! $(2(ก!"#

ก&12(ก# + ,

(4)

>##0 ก# ก 0 ก!"# $( !"ก!"#

$ก #!"

ก + ก!"#) (Home care) 0ก!"# (D1 ก('!(!"#

'!(!!"#0{ก'!(!2()) + #ก# @*ก#0 0#

0! )!"&ก!"#>

++ (Community Care) $ก () ก)+(.#ก-.&++"#*ก&

++$00 *0(1ก ก

&++)ก*0++>

++ |&ก!"#>++ 0 ก )('!(!/)(1(

.,*+ ก!"# ก

!"#) (Institution Care) $กก

*0ก) *ก/ + ก!"#) ก!"#)

*#0 !"#'!(! (ก //*I *+; 2547, <+#ก- "#

.; 2550 "#/*H "#.; 2550) ก. &/2!"ก!"#

'!(! $ก" 2(ก$&

ก# 0 '!(!ก2(0(>ก&(1 ก!"#)+&?#0!#H กH.ก/#0 D1ก! )!"

&.'!( ?ก) ก=

D0กก'!()(ก!"#,ก+

)!"&ก('!(!"#!"# (0ก

&(ก)(*ก+ #'!(!

0>*#ก+ "'ก!"#'!(! =

<0 '!(! ! )?กก#

&(1กก!"#2( 2

ก# ก $ *ก& (ก D0กก'!()(ก!"#,ก+)

!" %(02 ก/1ก- ก

!"# $ก1$ก<"<

)ก>&(

ก/1ก-)+/-?/

0&&ก!"#'!(!

)/2 2 กก " ) ก/1ก-((ก"#*1*)) กก!"#! ( ก + ./ -? (2546) /1ก- (กก!"#"#*1*)&'!(ก กก!"#&'!(!"#'!(!)&ก*- ก# 80 $'!(!

2(ก!"#ก'!(!"#'!(! ()&

ก*"#0+ก) '#ก* '!(! (กก!"#

)(ก$ )< *1

*)&'!(ก! )ก#

*H* (2551) ก/1ก-ก# '!(!

*ก/)#ก+)&

ก*"#.}# 140

* &(*ก)#0ก

<2 )(ก!"#2(/(ก'!(!"#

ก- * (กก!"#ก

"*"#ก*# "#(ก'!(!"#

+ #0)กxก ก/1ก- )+/-?/2("ก & .?*-

* (2552) D1$ก/1ก-+ก- ก ก(กก!"# $ ก'!(!)/2 >

&(!##,กก+ก!

)/2 *./.2545 )+( )ก/1ก-

(5)

ก!"# /1ก-)ก+ 2("ก ก!"#)/!!"#ก#'!(!

กก(*0+ #0'!(! "#

(*ก'!(! <&,*0 กก/1ก-* '!(! $*/<

'!(! /! 0 ก'!(!

! ก+ก0% )0 '!(!

&,*2 "#+ #02((0 ก'!(! &,* + #02(ก '!(! 2 '!(!"#0 ก'!(!

'!(!"#! )0 ">((ก)+(ก )#ก-.ก# กก "#*

/-?กก= <+ ก ก# 0 '!(! 2( กก "#ก

*((ก ก ">((ก)+(

กกก (+ ก " + 2(

*. ( 12 ก2( $ก/1ก-&

ก!"#&'!(! "(

ก ก!"#

$ก)!" %&'!(!)+

ก- 2! ก*.">(&

(กกก# )"#

&(+>)(&ก)(

ก!"# $ก>

,ก+ &&&ก/1ก- ก

@*'!(!)&ก*

ก 2 1 $ 2 .ก/ >(ก ก &(ก&

ก!"#&'!(! '#

"#H ก.ก 3 ก# 1H ก/1ก-& >)(=

1"#/-? )+( &(!# )+() ก/1ก- "#?&ก/1ก- 4 '#ก/1ก- "# 5 $ (

2. "##$ก##&'#()!* : '+,,ก-!

.'/*0/#(ก# 123#44"

.ก/) ")(

=1ก/1ก-+ก-/-?/) / ก &(กก ก!"#'!(! > )(=

)( '#ก ก#

"# '#2)/) W- /-?/

#,"#( &(0ก)%

&1ก&(% &(

,0% 2(0*"#

&'!(>, กก/1ก-) * กก/-?กก#

"#( * กก!"#

'!(!)ก( ก 4

<2("ก +ก

&,* "#/

ก กก +ก 2("ก

*/ +0+ ,* "#ก

&,* 2("ก &,*

D1$ก&,*ก$ % + 2 ก# "# $(

,*1*)ก!"# "#<

&,* 2("ก ก /1ก- "#/ ก กก

(6)

2("ก /ก กกก!"#

'!(!) , *ก "##ก-.

ก

2.1 '+,,/5)#67ก(,ก.'/*

0/#(ก# 123#444"

"#2(0$

<)ก*. 0กก) )+(กก!"#&'!(!&1ก

&ก)% ,)(. ก

*0)(2(*1*)! D1กก/1ก- ) # &ก

"ก# '#ก/1ก-2(

'# กก&ก!"#

* #ก# ก# 0 Costa-Font and Rovira-Forns (2008) * 2( '#)+

ก =) กก!"#

&'!(! #(ก Brau and Bruni (2006)

* 2(0 '#+ก ก) D0กก!"#&'!(! &.

Kennedy (2001) * # 0 2(

ก (ก&"#'!(!"#)ก กก '!( 2(!ก (ก

&. )& Reschovsky (1998) * 2(

@# 0 $)ก)+(ก Nursing home , Non- Medicare stays "#ก&(*ก )/# < '#ก/1ก-

& Stabile et al. (2006) * # 2(

0)! (ก)+( Home care $ก&? )+#(ก # 2(0ก < กก/1ก-

& Reschovsky (1998) * 2 '# < ก)+(ก Nursing home ก. (ก (Medicare, non-Medicare

stays Nursing home) "# #ก&(*ก Nursing home (, )

)(&* '#

ก/1ก-& Reschovsky (1998) *

* *H)+ก

< ก&(*ก ก0( '#ก/1ก-& Reschovsky (1998) * ก0( *H < & Nursing home , Non-Medicare stays "# Medicare stays "# < ก&(*ก

&. Stabile et al. (2006) * ก0(

'#)+# (ก)+( Home care

<D1#(ก Costa -Font and Rovira- Forns (2008) * ก0( '#)+

# =) กก!"#&

'!(! )ก Kennedy (2001) * # 2(กก( )+(

0 )+( &( (ก '!(!"#)ก(ก ก. 0%

2.2 '+,, 8!9:!;ก.'/*0/

#(ก# 123#444"

กก/1ก- ก &(*

2( ก/1ก-1+ก H*#

ก!"#&'!(!

*/ >& Stabile et al. (2006) H "ก */$< '#

ก#0ก)+(ก Home care ก# 0 */+

(ก)+( Home care (ก */<

D1#(ก Brau and Bruni (2006) *

*/+ =) ก,ก!"#

&'!(!(ก */<

(7)

+0+ Kennedy * )/?ก +0+ "ก-ก"## (ก '!(!"#)กกก '&&.

Reschovsky (1998) *

*H)+ก <

& Nursing home 0 " Non-Medicare stays "# < ก&(*ก &.

Brau and Bruni (2006) 2(H

# ก- . "# )#0ก D0ก ก!"#&'!(!"#2(

* '+<กก#ก ก 2 0ก)ก&?

)0&! )*1* &. '#ก/1ก-

& Costa-Font and Rovira-Forns (2008) * +ก)+ 40-50 t =)D0กก

!"#&'!(!กก )+ 0 ,* Reschovsky (1998) 2(

* '!( ,*"# *H )+# < & Nursing home , Non-Medicare stays "# <

ก&(*ก &. & Stabile et al.

(2006) * '!( ! '#)+ก < (ก)+( Home care D1#(

ก Kennedy (2001) * (ก'!(!"#) ก *H !ก#

! กก # ! ก0

&,* '# ก!"#

&'!(!0ก0ก&1ก=

>ก=y2(กก กก /1ก-* ก &( #ก#

)ก,&,*

&,* Stabile et al. (2006) * '!(! &,*

2 (ก)+( Home care )+ก

กก '!( &,* < D1#(

ก Costa-Font and Rovira-Forns (2008) "#

Kennedy (2001) > Costa-Font and Rovira- Forns (2008) * # &,*2 '#

)+ก =) ก ก!"#

&'!(!กก # &,* " )

& Brau and Bruni (2006) * # &,*

& 2 )2 #0กD0กก

!"#&'!(! &. Kennedy (2001)

* *H # &,*ก#

02 ก(กก!"#

,*1*)ก!"# Reschovsky (1998) * "(กก!"#) ก (ADLs), '!( <&,*

"#*Wก *H)+ก

& Nursing home , Non-Medicare stays '#ก/1ก-& Nyman et al. (1997) *

",*1*)ก&(("#

ก+ #0ก#0( ก( ก

#0ก )+( Nursing home กก Adult foster care

<&,* Nyman et al. (1997)

* )ก)&

'!(! (Control over decision) $) +ก ก#0ก)+( Adult foster care กก Nursing home < &. Costa-Font and Rovira-Forns (2008) * ,ก.

!(ก2(( (Perceive own disability) "#ก2*"* '#)+

ก < =) กก )& Campen and Woittiez (2003) 2(

" ,'!()+(ก,&,* * '!(*0&(กD1 ,&,* ก

(8)

(ก)+(ก Home care , % "ก กก2ก# 0'!(

(กก!"#ก")+(ก.

(IADL) $)+ก กก + #0,)( กก '!(

(กก!"#,0% " $ )+# "ก!"#ก-*# &.

'!( (กก!"#+DD(

$)+ก "ก!"#

ก-*# " $)+#

"ก!"#,)( "#* ก. #D1

$2&( กก>*# '!(! "

'!(y ก#*ก "#'!(y0 '#)+

ก ก)+(ก+ #0,)("#ก

!"#ก,* &. '!(! (ก ก!"#)ก ")+(ก."#

'กก '#)+ก "

ก!"#ก,* "#'!()+(กก!"#

&,*"#กก '#)+#

"ก!"#ก,* " '#)+ก

"ก+ #0)กก '# ก!"#

&'!(!0ก/1ก- Stabile et al. (2006) * # ก/1ก-!

(ก)+( Home care )+กกก # ก/1ก-ก < &.

Brau and Bruni (2006) * # ก/1ก- , H "##

)#0กD0ก,,ก!"#

&'!(!

/ '# ก!"#

&'!(!0/ ก ก ก '#ก/1ก-& Nyman et al. (1997)

* '!(!#0ก)+( Adult foster care )(

<ก ก/& *ก #((-

*ก/ $ "# ก 0 2( &. '!(!D1#0ก Nursing home )(<กก!"#

ก"*"##,"# Stabile et al.

(2006) * & Public home care program '#)+ก <

(ก)+( Home care &. Brau and Bruni (2006) * = '#)+#

.,*&ก&,*&?"#'!($

+กก&,*ก+)#0กD0 ก,ก!"#&'!(!

3. "(<=ก#)>ก6

3.1 "&:"?'5ก=:"กก#539ก"(<=

ก#)>ก6#@/!=@

0(ก/1ก- &(ก

&ก2(D1&(!#&ก)+(ก!"#

&'!(! '!(1#0ก)+(H ก=&(!#

ก0 '!(!>ก(ก.

ก ก) )+(ก!"#

, %*0?&&(!#&

ก &(!# )+(ก# 2(ก ก&>ก Bกก#

ก!"#&'!(!)&

ก*C )ก.ก) ก &)+

(ก)+()+. + &

ก)+(ก0# )+(ก "

'!(!1(ก)+(ก

!"#>">D1" ก 3

(9)

2("ก )+(ก" )+(ก

"#2 )+(ก " 0 ( )(ก'!( H ก.&ก/1ก- )+("# Ordered Logit Model

) ' ก/1ก-+ก-

& ก )+(H ) กKennedy (2001) "# Nyman et al.

(1997) )+("# Logistic regression model

> Kennedy )+("#ก# *0/1ก-1 '# (ก'!(!"#)ก

&. Nyman et al. )+("#) ก/1ก- $กก#0ก)+(

ก )+(ก *ก Adult foster care "# Nursing home Campen &

Woittiez (2003) )+("# Multinomial logit model *0/1ก-*H #ก-.&

'!()+(กกก Home care D1 4 ,0 ก!"#,)( ก!"#(ก,* ก

!"#( "#ก!"#*# Joan Costa- Font and Joan Rovira-Forns (2008) )+("#

>**0/1ก-/-?ก"#

ก=) Reschovsky (1998) )+(

"# Bivariate probit model )ก/1ก- ก& Nursing home D1(

#ก&(*ก ก#0ก*ก 0"#"#02&ก Brau &

Bruni (2006) )+("# Multinomial logit

"# Multinomial probit model *0/1ก-1

"'ก#0ก=) ก,ก

!"#"#)+( Nested logit /1ก- ก#0กก,ก!"#&

'!(!>#0ก) D0ก 02 D0ก

3.2 2,3//5)#67&(A(

"#/-? )+()ก /1ก- $"# Ordered Logit D1

"$""(ก)+(

ก!"#,)% "(

$" (, %2("ก /-?ก # ( +ก #ก-. "#(

&,*) "#(0&'!(!

$ก"( ก .ก"2(

i i

i X u

Z^* =α + ′β +

0

i =

Z ^if 0

* <µ Zi (ก. 2 )+(ก)

1

i =

Z ^if 1

* 1

0 µ

µ <Z ≤ (ก. #0ก)+(ก)

2

i =

Z ^if µ1 <Zi^* (ก. #0ก)+(ก " )

> ⁱ '!(! $ )ก ,-. (ⁱ⁼¹^,²^,...,^N)

*

Zi Latent variable ก#&

&(ก)+(ก/2 )+(

ก!"#& ⁱ $

" 2 ก=2(

Xi ก"( ("+

."#/0" )

β ก&HX&"

(

> ^µ $#&

.ก @# &"(" #"#

(10)

$" 2 ก=2( "

ก=2( * (ก )+(02 )+(ก0!ก )+(ก βT$ HX"/&'#ก&

XT $ '!(!)+(ก!"#

D1!ก.ก ก + ก βT $ก ก*&1

& XT # $&ก2 )+(

ก!"# "#* $

&ก)+(ก!"# "

กก)ก/1ก- 2(ก . Marginal Effects &"( XT

ก( Marginal Effect ")(=1ก

# "# $ #0ก#0ก)%

(+ ^j⁼² #0ก)+(ก" ) กก ก# "#&"( XT D1.

2(ก

{ j i j i }T

T

i F X F X

X j

Z ) (µ α β) (µ α β)β

Pr(

1

*

− ′

′ −

−

′ −

∂ =

=

∂

−

> ^F^(⋅⁾$ cumulative distribution function & û_i D1ก. & Ordered Logit 2("ก ^F⁽^z⁾⁼ê^z^/(¹⁺ê^z⁾

3.3 08&13

&(!# )+()ก.ก

$&(!#กกก!"#

'!(!&0)&ก*

4 ก,*H 30 2552 +ก|&ก0 0 '!(! 60 t&12 )&ก*

0 #*0 ก=&(!# 1,000 0> ก++ 50 #=D1

ก! ) 50 &&ก*

'!(! ก$ 1,623

&(!#"("#"&ก .ก&ก!"#2(

กก&(!#>)+(",-.

'!(!)&ก*D12(ก

" % D12("ก ก,ก >

#>&ก,&,*

&++2 >ก ก 3 *./.2546-2547 "#ก+ก

!)/2 *./.2545 ก)+(

,ก >&'!(! "

ก,( (

#))+('!(!) &

.กก", 0("#+/'!(!

ก)+(,&'!(!

"&>กก!"#

)'!(! &(!#ก กก

!"#'!(! &//*I *+ (2549) ก)+(ก!"#'!(! "#"

ก)กxก The Barthel Index ก)+(

ก)กxก

&'!(!

",-.ก( 5

< 1 &(!#2&'!(!

2 #ก-.&0 3 ,

&,*&'!(! (ก(&(

ก ก,&,*2 ,ก >

#> ก,(

"#ก)กxก

(11)

) 4 ก!"#'!(!)

"# 5 <"#(ก)ก!"#

"(D1(1 (กก!"#" #,2(

ก&(ก ก(ก)ก)+(ก

!"#'!(! 5 ,2("ก (1) ก('!(!"#ก/!ก '!(!"#

'!(!!"# ( (2) ก!"#'!(!

@*)+ #ก#)>*# / (*ก+ / #'!(! (3) ก

!"#'!(!)% ( 0 2-3 ) )>*# / (*ก+ / # (4) ก!"#'!(!)(*ก+ /

#'!(! > #ก(&,*

!"# " 2 "*0*#!"#

0 "*"#*#! ( (5) ก!"#

'!(!)>*#> "*

*# "##ก(&,*0%

!"# ก (1) (2) "# (3) $ก!"#

'!(! ( ก (4) "# (5)$ก

!"#'!(!) >&(" #&(

@# &ก" #,)(ก'!(!ก ,-."# ,)(% )+(

ก02 #0กก( B)+(ก

" C B)+(กC "# B2 )+(ก" C ก&1"## 10% "# 20% *0 ก ก# "#&

)+( 1)(+&(!# )+()ก ก&1ก '!(! ก*0

# ก# ก,) ก/1ก-

2(ก@# &กก# " # ,$@# &" #ก 2(ก กก'!(! (>*#"#

#) "#/!ก '!(!"#'!(!

)&ก* @# &ก 5 , 2(กก0 ก (1) 9,000 0 ก (2) 700 ก (3) 1,300 0 ก (4) 16,000 0

"#ก (5) 36,000 0

" )+()"#2(

2() 1 D12(&(!#ก&( %>

*ก )(#(ก.- ก/ 2() 2 &

"# &"<2() 2

3.4 &&A(7!

?<&ก.ก 2 &ก!"#

'## 2( '#ก '!(! #ก-. 2 ">(

)+(ก!"#ก'!()(ก(

$ !ก '!(! ($&

(")(=1?) '!(! ,*

> ( 0"กก! '!(!

,*1*! '!(! ! )0 ,*1*! ">( )+(ก(

$ !ก '!(! ! )0 &

/ก,*)ก'#ก!"#2( ( +ก)0( ก!"#>

+ก) 2(/! ก) ">( )+(ก( $ ก

(12)

A#/=: 1 : ")ก.ก+&กก!"#>'!()(ก

'#45B A"2'# 3ก6$4A"2'# #345=

A"2'#A&

ก))+(ก (ก

!"# 5 ,)

""# )+(ก" = 2 )+(ก = 1 2 )+(ก = 0

&ก" #, "+. &(!# )",-.

2(&'!(! 0 "+. &(!# )",-.

2(&+ก0 0

"+. &(!# )",-. (2 '!(!)

'+,,/

5)#67ก(,

'!(!0! ($

&

" )+ = 1 2 )+ = 0

*/&'!(! " < = 1, + = 0

&'!(! "+. &(!# )",-.

,* > " > = 1, 0% = 0 ,* (

"กก!

" ( "กก! = 1, 0% = 0 '+,,"!

.3 ('#4Dก#

/& 234 .0BE)

ก*1* (ADL) " 1 (*1*); )+ = 1 2 )+ = 0

2 (*1*ก); )+ = 1 2 )+ = 0 3 (ก#); )+ = 1 2 )+ = 0 ก*1*&0

'!(!/!

"+. "#&(!#! 2 (=ก ก 15t+'!(! / +ก ) +ก '!(! $

+ก)0 '!(!/!

"+. &(!# )",-. (2 '!(!)

+ก)0 '!(!/! กก#

"+. &(!# )",-. 2 '!(!กก#

ก ! )0 ก " )+ = 1 2 )+ = 0 '+,, 8!

#"5#9!

ก!"#'!(!>+ก

&0

"+. "ก&(

=:&: กก/1ก-

(13)

A#/=: 2 : &"< กx)"#

D9:A"2'#

A:. 1/. 5G3=: 5=:/5!

&A#7!

2(&+ก0 0 0.00 220,000.00 23,553.63 26,596.18 '!(!0! ($& 0.00 1.00 0.59 0.49

*/&'!(! 0.00 1.00 0.63 0.48

&'!(! 13.00 89.00 48.82 13.64

,* > 0.00 1.00 0.07 0.26

,* ( "กก! 0.00 1.00 0.41 0.49 ก*1* 1 (*1*) 0.00 1.00 0.04 0.20 ก*1* 2 (*1*ก) 0.00 1.00 0.01 0.11 ก*1* 3 (ก#) 0.00 1.00 0.01 0.12 ก*1* 4 (() 0.00 1.00 0.03 0.17 ก*1*&0 '!(!/! 0.10 2.00 0.53 0.26 +ก)0 '!(!/! 0.00 12.00 2.69 2.07 ก ! )0 ก 0.00 1.00 0.71 0.45 ก!"#'!(!>+ก&0 0.00 51.00 7.21 11.22

=:&: กก&(!#&>ก

4. H3ก#)>ก6

'#ก.ก&ก

!"# " ก,&

ก!"# ("#ก!"#

) 3 "'#ก.

ก ก!"#'!(! (ก , (1) ก('!(!"#ก/!!"# ( (2) ก!"#+ #ก#) "#

(3) ก!"#'!(!) * 2 $ก())('#2) ก &ก" #, '#

ก&( (ก)+(ก ก# 0

ก&ก# !&1 กก=## )(&2(* ก '!(!0&'!(! 2(!

">( )+(ก " ก=!2 (

กก '#ก/1ก-* '!(!

! ),*1*! ">( )+(ก!

ก "#0 '!(! /! ) 0 )ก'#ก!"#

2( (กก!"#

กก0(ก ก# 0 '!(!

/! )0 ,*1*!0 '!(! 2(/ ก)0

(14)

">((ก)+(กกก '!(! /

! )0 /! )0 ,*1*0/! ก ก

* '!(!*/<0 ,*

> ">( )+(ก!"#ก 0(ก */+0,*

0% )(&&D1)ก/1ก- )+(+ก)0$""

* *H" quadratic ก ก!"#, ก# 0

">(&()+(ก!"#ก 0 %*&10+ก) 0 ( " (กก# # (#20+ก *ก&1

'#ก.ก) &

ก!"#+ #ก#)"#ก

!"#'!(!)$2) กก(ก ก(

'!(!"# ( "ก กก. &

'!(!"#'!(! (* " = ก# 0 ก"ก * )ก. &ก,

# '!(! ,*1* ">(

(ก)+(ก!"#>ก0 < 0 กก# 0 กก

* ก2)+(ก) &1ก ก 2ก"2ก# '#

)#W- ก=" 2 < "

2( < (ก)+(

ก! '#ก/1ก-) #(ก '#&ก.&ก!"#

'!(!) 2(ก# 1)#

2 ('#ก.ก Marginal Effect

"! ) 5)

4 "'#ก.ก ก!"#'!(!))ก.

ก, (4) ก!"#'!(!

)(*ก+ / #'!(! "# (5) ก!"#'!(!)>*# *

@*'!(! ! ),*1* ">(

(ก)ก)+(ก!"#) ) ! กก* 0ก=

'#) กก&ก!"#

(, ก# 2"#( ก(

/-?ก ก# 0 ก'#ก.ก ) 3 =2( (&ก 2('# < &. กก=

* 2(&'!(!$02&$) กก,# >@* ) ก. &กก!"#)>*# D1

@*2(&'!(! '#ก < กก ('#ก.ก Marginal Effect "! ) 5)

(15)

(16)

(17)

(18)

(19)

(20)

5. /8

ก# 2( 2)

! )" ก# ' ! '!(! ก# "#ก# D1 +ก! *&1)" "#

*(ก ก!"#'!(!>+ก

&" * #*)2

">(&(กก&1 ,&

#!ก#*&10ก* ( + #0 ก)ก!"#* " & (#

'!(!2 #!ก#!"#*2(

" 0" " 2 $"#

<&ก!"# $ ก ก&1#

&0ก ก ก!"#

$ก)!" %&'!(!+

ก- &&&ก/1ก- ก@*

'!(!)&ก* &(!# )+() ก/1ก- $&(!#0 '!(! 60 t&12กกก!"#

'!(!&0)&ก*&

>ก Bกก#ก!"#

&'!(!)&ก*C D12(

>กกก (&,* (.) ' !#H

"#*I'!(!2 (.'.) '!(!

ก$ 1,623 "

,-.2(@# "#

# 2&ก!"#, % '!(! 2("ก (1) ก('!(!"#ก/!ก '!(!"#'!(!!"# ( (2) ก!"#

'!(!@*)+ #ก#) (3) ก!"#'!(!)% ( 0 2-3 ) ) (4) ก!"#'!(!) (*ก+ / #'!(! (5) ก!"#

'!(!)>*# "#'!(!"

(ก B)+(ก" C B)+(

กC 0 B2 )+(ก " C "#

)+()ก/1ก-$"# Ordered Logit ) ก "( *. "

$/-?ก #&

'!(! "#(0

'#ก/1ก-),** '!(!

! ),*1*!0'!(! /) 0 2 '#ก!"#2(

(+ ก*1*&0! 0 2 2(! )0 ก) (ก ก!"#ก, ก*

'!(!*/<0'!( ,*>

">( )+(ก!"#ก0 (ก */+0,*0% &

&0 #=ก#0%ก= )(ก ก!"#ก,0ก '#

ก/1ก- 2(0&(=

/-?ก '# ก))+(ก!"#

=2(+ 2(&'!(!"#2(

0 '# &ก"ก,) /ก ก2(*&1'!(! ">() ก)+(ก!"#ก&1 ( '#+# < @*ก ('!(!"#ก/! !"#'!(! ("#

ก!"#'!(!@*)+ #ก#) ก,0D1! )

!"( ##ก=2()(*&1" )

(21)

ก=0ก !ก D0 ก2(

+>&ก/1ก- 2 ก*'#ก)(กก

!"#'!(! ("#)

*ก&1*0 (ก

*&1)0กก#

+ก"#0) (ก ,ก+"#ก2 "ก2)#ก-.

&Hก*0)(&( ก

!"# .,* >@*

ก '!(!"#'!(!"#ก!"#'!(!

@*)+ #ก#

5ก#8/(/

.?*- *. (2552). "&A8/ก##(ก# 8!

ก# 123#44"25'J!/ก#-#

H181/.K!'#45)?. *H

#ก!/-?/.}

&+/-?/ T#ก.

#.

*H* . (2551). ก#)>ก6"&A8/ก#

0/H181/.=:Eก)K!L!#(3 5กD!50Aก#./5E&-!#234'#(-

&$N3. *H<<*#- /.} &ก*#

'!(! .}# T#ก.

#.

<+#ก- "#* . (2550).

B5กD!กก#K-8#(ก#.0BE 234ก# 123H181/.K!'#45)?.

H.& ก H.&.

//*I *+. (2549). #/!"(,G

&1#$* O#/ก##4ก# 123#44

"K!##"-#H181/..

ก*: กt

(/2) ก.

/*H "#0) ,ก *. (2549).

#/!"(,G&1#$* O#/ก#

"!/*"&#185#9:/ #4ก# 123 H181/.=:5'J!/ก#0/?. .

*#/ T#ก.#.

/*H "#0) ,ก *. (2550).

#/!"(,G&1#$* O#/ก#

"!/*"&#185#9:/ #4L!

#(3H181/.. 0& &,*

กก*0ก.

./ -?. (2546). "&A8/ก#

ก# 123234"&E>/EK,0/H18#

#(ก#,กก# 1230/H18 123H181/.

K!50Aก#./5E&-!#. *H

<<*#/.} &

ก*#'!()< .}#

##.

Brau, R. & Bruni, M.L. (2006). Elicit the Demand for Long Term Care Coverage: A Discrete Choice Modelling Analysis. Working Paper. The Fondazione Eni Enrico Mattei Note di Lavoro Series Index.

Campen, C.V. & Isolde, B.W. (2003). Client demands and the allocation of home care in the Netherlands. A multinomial log

(22)

it models of client types, care needs and referrals. Health Policy. 64, 229-241.

Costa-Font, J. & Rovira-Forns, J. (2008). Who is willing to pay for long-term-care insurance in Catalonia? Health Policy.

86, 72-84.

Kennedy, J. (2001). Unmet and undermet need for activities of daily living and instrument activities of daily living assistance among adults with disabilities: Estimate from the 1994 and 1995 Disability Follow-Back Surveys. Medical Care.

39(12): 1305-1312.

Nyman, J.A., Finch, M., Kane, R.A., Kane,R.L.

& Illston, L.H. (1997). The substitu- tability of adult foster care for nursing home care in Oregon. Medical Care.

35(8): 801-813.

Reschovsky, J.D. (1998). The demand for post- acute and chronic care in nursing home.

Medical Care. 36(4): 475-490.

Stabile, M., Laporte, A. & Coyte, P.C. (2006) Household responses to public programs.

Journal of Health Economics. 25: 674- 701.