Current Developments in Social Care Services for Older Adults in the Czech Republic: Trends Towards Deinstitutionalization and Marketization

ABSTRACT

Deinstitutionalization and marketization of eldercare has been delayed by 20 years in the Czech Republic compared to Western Europe, and it takes place in a completely different context, characterized by the legacy of communism, a growing older population, and less generous public subsidies. This study is the first in the Czech Republic to examine how deinstitutionalization and marketization effect implementation of these principles on the availability and quality of eldercare services at regional and municipal levels. A mixed-method approach was used, combining several data sources (policy documents, administrative data, statistics, expert panel, and secondary use of qualitative data). The findings suggest that the support for and availability of home-based care has declined, despite the ever-increasing number of older adults and policy preference for deinstitutionalization. Furthermore, home-based services have failed to adjust to growing care needs of older adults (e.g., inflexible schedules, limited provision of time-demanding care, inadequate staff composition). This situation occasioned an unintended outcome: the emergence of nonregistered, semilegal, for-profit nursing homes offering low-quality care and poor working conditions, and subject to no quality control. The health and even lives of older adults are at risk if they choose such services. Research is needed to study older adult decision making and offer them tools to identify and avoid questionable services.     

Ellsberg paradox: Ambiguity and complexity aversions compared

We present a simple model where preferences with complexity aversion, rather than ambiguity aversion, resolve the Ellsberg paradox. We test our theory using laboratory experiments where subjects choose among lotteries that “range” from a simple risky lottery, through risky but more complex lotteries, to one similar to Ellsberg’s ambiguity urn. Our model ranks lotteries according to their complexity and makes different—at times contrasting—predictions than most models of ambiguity in response to manipulations of prizes. The results support that complexity aversion preferences play an important and separate role from beliefs with ambiguity aversion in explaining behavior under uncertainty.     

A Note on the Compatibility of Bivariate Copulas

This article answers to a problem by Kolesárová, Mesiar, and Sempi about the class of all copulas that are compatible with two given bivariate copulas A and B. It is shown that, even if A and B are not completely dependent, the class of all copulas compatible with A and B may consist of a singleton.     

Estimation of the Intensity Parameter of the Germ‐Grain Quermass‐Interaction Model when the Number of Germs is not Observed

The Quermass‐interaction model allows to generalize the classical germ‐grain Boolean model in adding a morphological interaction between the grains. It enables to model random structures with specific morphologies, which are unlikely to be generated from a Boolean model. The Quermass‐interaction model depends in particular on an intensity parameter, which is impossible to estimate from classical likelihood or pseudo‐likelihood approaches because the number of points is not observable from a germ‐grain set. In this paper, we present a procedure based on the Takacs–Fiksel method, which is able to estimate all parameters of the Quermass‐interaction model, including the intensity. An intensive simulation study is conducted to assess the efficiency of the procedure and to provide practical recommendations. It also illustrates that the estimation of the intensity parameter is crucial in order to identify the model. The Quermass‐interaction model is finally fitted by our method to P. Diggle's heather data set.     

Independent Quadratic Forms in 3-Variance-Component Models

This article addresses derivation and existence of quadratic forms that were suggested by Burch (2007 Burch , B. D. ( 2007 ). Generalized confidence intervals for proportions of total variance in mixed linear models . J. Statist. Plann. Infer. 137 : 2394 – 2404 .[Crossref], [Web of Science ®] , [Google Scholar]) for procedures for inference on variance components in mixed linear models in combination with generalized fiducial inference. A relatively simple algorithm leading to the required quadratic forms in a general 3-variance-component model is stated and designs for two-way ANOVA models without interactions that permit Burch's procedure are characterized. This complements developments in the original article by Burch.     

Divergence-based tests of homogeneity for spatial data

The problem of testing homogeneity in contingency tables when the data are spatially correlated is considered. We derive statistics defined as divergences between unrestricted and restricted estimated joint cell probabilities and we show that they are asymptotically distributed as linear combinations of chi-square random variables under the null hypothesis of homogeneity. Monte Carlo simulation experiments are carried out to investigate the behavior of the new divergence test statistics and to make comparisons with the statistics that do not take into account the spatial correlation. We show that some of the introduced divergence test statistics have a significantly better behavior than the classical chi-square test for the problem under consideration when we compare them on the basis of the simulated sizes and powers.     

Behavioral biases and the representative agent

In this article, we show that behavioral features can be obtained at a group level even if they do not appear at the individual level. Starting from a standard model of Pareto optimal allocations, with expected utility maximizers but allowing for heterogeneity among individual beliefs, we show in particular that the representative agent has an inverse S-shaped probability distortion function as in Cumulative prospect theory.     

Application of Correspondence Analysis in the Assessment of Mine Tailings Dam Breakage Risk in the Mediterranean Region

A new statistical approach for preliminary risk evaluation of breakage in tailings dam is presented and illustrated by a case study regarding the Mediterranean region. The objective of the proposed method is to establish an empirical scale of risk, from which guidelines for prioritizing the collection of further specific information can be derived. The method relies on a historical database containing, in essence, two sets of qualitative data: the first set concerns the variables that are observable before the disaster (e.g., type and size of the dam, its location, and state of activity), and the second refers to the consequences of the disaster (e.g., failure type, sludge characteristics, fatalities categorization, and downstream range of damage). Based on a modified form of correspondence analysis, where the second set of attributes are projected as "supplementary variables" onto the axes provided by the eigenvalue decomposition of the matrix referring to the first set, a "qualitative regression" is performed, relating the variables to be predicted (contained in the second set) with the "predictors" (the observable variables). On the grounds of the previously derived relationship, the risk of breakage in a new case can be evaluated, given observable variables. The method was applied in a case study regarding a set of 13 test sites where the ranking of risk obtained was validated by expert knowledge. Once validated, the procedure was included in the final output of the e-EcoRisk UE project (A Regional Enterprise Network Decision-Support System for Environmental Risk and Disaster Management of Large-Scale Industrial Spills), allowing for a dynamic historical database updating and providing a prompt rough risk evaluation for a new case. The aim of this section of the global project is to provide a quantified context where failure cases occurred in the past for supporting analogue reasoning in preventing similar situations.     

The Family Context of Cohabitation and Single Motherhood in Latin America

The dramatic shift from marriage to cohabitation during the last four decades in most Latin American countries, even among the upper social strata, begs the question as to the living arrangements of cohabiting couples and single mothers. The new “Family Interrelationships Variables” in the IPUMS samples of Latin American censuses facilitated the construction of an enlarged LIPRO typology. LIPRO classifies individuals with respect to the types of households in which they are living. The results indicate that cohabiting women and single mothers aged 25 to 29 are frequently found in their parental households or in other extended or composite households. However, there are large variations depending on country and education. For instance, cohabitation is mainly in nuclear households, as in Europe, in Puerto Rico, Costa Rica, Brazil, and Argentina. It occurs mainly in the context of extended households in Peru, Bolivia, Colombia, Venezuela, Panama, and Cuba. Mexico and Chile occupy intermediate positions. In all instances co‐residence of cohabiting couples with other kin drops significantly upon the transition to parenthood, at which point there are no longer any differences between cohabiting and married couples. Single mothers, however, continue to co‐reside in extended or composite households to a larger extent, and this holds particularly for the better‐educated among them. This analysis illustrates that cohabitation of the traditional type and of the “Second Demographic Transition” type are found alongside each other, with one being more important than the other depending on country and on educational level or social class within each country.