The Effect of informal caregiving on caregivers’ healthcare utilization in China

A fast-ageing population implies an upsurge in demand for caregiving. We examine the causal effect of informal caregiving on caregivers' realized and forgone healthcare utilization based on data from China. Accounting for the potential endogeneity in caregiving, we find that caregivers not only use more outpatient care and self-treatment, but are also more likely to forgo necessary inpatient care. Caregiving also increases the out-of-pocket expenditures of all types of healthcare. Further mechanism analysis shows that caregiving worsens caregivers' health and takes up time and economic resources for healthcare utilization, which causes the coexistence of increased realized and forgone healthcare use. Heterogeneity analysis reveals that those with tighter budgets and higher marginal costs for healthcare (e.g. rural or less educated caregivers) tend to bear larger increases in caregiving-driven health costs. Our results shed light on the overlooked benefit of long-term care policies if accounting for the spillover effects of informal care provision on caregivers' healthcare use, particularly for disadvantaged groups.