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06.04.2018 | Original Research | Ausgabe 9/2018

The European Journal of Health Economics 9/2018

Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment

The European Journal of Health Economics > Ausgabe 9/2018
T. Lehnert, O. H. Günther, A. Hajek, S. G. Riedel-Heller, H. H. König
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10198-018-0968-0) contains supplementary material, which is available to authorized users.



Most people prefer to “age in place” and to remain in their homes for as long as possible even in case they require long-term care. While informal care is projected to decrease in Germany, the use of home- and community-based services (HCBS) can be expected to increase in the future. Preference-based data on aspects of HCBS is needed to optimize person-centered care.


To investigate preferences for home- and community-based long-term care services packages.


Discrete choice experiment conducted in mailed survey.

Setting and participants

Randomly selected sample of the general population aged 45–64 years in Germany (n = 1.209).

Main variables studied

Preferences and marginal willingness to pay (WTP) for HCBS were assessed with respect to five HCBS attributes (with 2–4 levels): care time per day, service level of the HCBS provider, quality of care, number of different caregivers per month, co-payment.


Quality of care was the most important attribute to respondents and small teams of regular caregivers (1–2) were preferred over larger teams. Yet, an extended range of services of the HCBS provider was not preferred over a more narrow range. WTP per hour of HCBS was €8.98.


Our findings on preferences for HCBS in the general population in Germany add to the growing international evidence of preferences for LTC. In light of the great importance of high care quality to respondents, reimbursement for services by HCBS providers could be more strongly linked to the quality of services.

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