A Fuzzy Approach to Long-Term Care Benefit Eligibility; an Italian Case-Study

Abstract

We propose a fuzzy approach to quantify a cash-benefit for older people in need of Long-Term Care, e.g., affected by limitations in daily-living activities. Many approaches exist at national or regional level in Europe, and most legislation determine eligibility to public care-programs using rule-based approaches which aggregate basic health-outcomes into main pillars and then into eligibility categories. Population ageing and improvements in longevity make access to care a crucial problem for Western economies. In this paper we focus on Italy, where public-care eligibility is decentralized at regional level and often based on check-lists, and in particular on the Toscana region. We investigate the extent to which the existing legislation violates basic properties of monotonicity and continuity, thus potentially increasing inequity in care access. We then propose the introduction of a fuzzy approach to the eligibility determination, which allows for smoother results and reduced inequality.