The role of immigrant caregivers in improving the welfare of elders and reducing public health costs

Abstract This paper examines the impact of paid migrant home care on elderly health outcomes in Italy. The results show that an increase in migrants’ presence reduces both the frequency and duration of hospitalisations. Specifically, a 1 percentage-point increase in the migrant-to-elderly ratio leads to a decline in long-term and rehabilitation inpatient (LRI) admissions of 118 cases per 100,000 elders, with no measurable effect on acute inpatient stays. There is also a reduction in the average length of stay of 0.141 days, rising to 0.956 days for LRI cases. These effects are driven by diagnoses related to traumatic injuries, musculoskeletal, and genitourinary conditions — areas closely linked to home mobility and care management. Back-of-the-envelope calculations suggest that the average annual increase of 1.3 percentage points in the migrant-to-elderly ratio observed during the study period corresponds to an 8% reduction in elderly LRI hospitalisation costs, equivalent to 252.3 million euros.