CC BY
2DOI: 10.29141/2658-5081-2023-24-2-3 EDN: PXUIGF JEL classification: J11, J14, I31
Ivanna I. Deren Vladimir Law Institute of the Federal Penitentiary Service,
Vladimir, Russia
Kseniya A. Samofatova State University of Vladimir named after Alexander
and Nikolay Stoletovs, Vladimir, Russia
The multiplier effect from the development of a long-term care system for elderly citizens
Abstract. Lately, the demand for long-term care for the elderly as well as the requirements to its quality have been increasing worldwide. The annual growth in the volume of state investment in the system of long-term care for the elderly generates multiplier effects for the development of certain types of activities in the services sector. The article aims to devise a method for calculating these effects. The methodological basis of the study is the Keynesian multiplier and institutional theory. Statistical and economic methods are applied. The paper performs calculations using the own method based on the Keynesian approach and including a system of linear equations. The data comes from twelve pilot social welfare institutions of the Stavropol krai (Russia). The authors formulate the own definitions to the concepts "multiplier effect in the long-term care system" and "multiplier of the development of the long-term care system (for services)". According to the results of testing the suggested method, the annual increase in state investment funds allocated for the long-term care system leads to an increase in the expenditures of pilot institutions on various types of services (transport, utilities, education, communications, catering, cultural events, health resort treatment). The findings expand theoretical and practical knowledge about the peculiarities of determining the multiplier effect.
Keywords: multiplier effect; long-term care system; elderly citizens; social services; multiplier.
For citation: Deren I. I., Samofatova K. A. (2023). The multiplier effect from the development of a long-term care system for elderly citizens. Journal of New Economy, vol. 24, no. 2, pp. 50-65. DOI: 10.29141/2658-5081-2023-24-2-3. EDN: PXUIGF. Article info: received December 7, 2022; received in revised form February 9, 2023; accepted March 30, 2023
Introduction
Demographic changes in Russia and the world, in particular, the annual growth of elderly population, called for radical transformations in the social sphere. For instance, 2013 saw the creation of the social care system, which ensures the provision of household assistance, social-medical, social-legal, social-psychological, social-pedagogical, social-labour services, etc., and is regulated by the Federal law of December 28, 2013 no. 442-FZ "On the basis for social care for citizens in the Russian Federation"1.
At present, there are not enough social welfare institutions for elderly citizens with disabilities, and infrastructure accessibility of these institutions does not meet the needs of the social services market and the existing demand. To settle this problem, the system of long-term care for elderly citizens (SLTC) was created. Its introduction at regional level started in 2018 and continues in 2023.
This system is a timely response to a demographic problem consisting in the increase in the share of the elderly people, as well as to the problems related to a decrease in the number of the social care workers and the volume of social care services.
The system of long-term care is financed from the federal and regional budgets. Additional investments lead to the growth of the gross regional product and gross domestic product, diversification of the social sphere and development of the competition between providers of social care services for the elderly. All together they result in a multiplier effect from the SLTC introduction and functioning in the constituting territories of the Russian Federation.
The study aims to determine the multiplier effect, which arises in the related industries due to the development of the system of long-term care for elderly citizens who lost the ability to self-care. To accomplish this purpose the following objectives were completed:
- to explore the content of the concepts "multiplier effect" and "multiplier";
- to formulate own definitions to the concepts "multiplier effect in the long-term care system" and "multiplier of the development of the long-term care system (for services)" allowing for the views presented in the scientific literature;
- to propose a method for calculating the values of the multiplier of the development of the system of long-term care for elderly citizens in the case of services;
- to calculate the values of the said multiplier based on the data from twelve pilot institutions of the Stavropol krai;
- to identify the sphere of services with the strongest multiplier effect.
1 On the basis for social care for citizens in the Russian Federation: Federal law of December 28, 2013 no. 442-FZ. In: ConsultantPlus. http://www.consultant.ru/document/cons_doc_LAW_156558/. (In Russ.)
Calculation of the services multiplier and the multiplier effect from the development of the long-term care system: The theoretical and methodological basis
There have been numerous Russian and foreign studies investigating various aspects of formation of the multiplier effect and the multiplier (Table 1). Most of them rely on the theory of multiplier effect developed by Kahn [1931] and Keynes [1936].
Table 1. Interpretation of the concepts "multiplier effect" and "multiplier"
Source Interpretation
Multiplier effect
Kahn [1931] Multiplier effect is mentioned in the economic theory for the first time and is defined as a means to reduce unemployment and overcome economic depression
Keynes [1936] An increase in investment expenditure raises the income by the value of the multiplier (the national income grows by more than the amount of the increase in investment expenditure)
Weller et al. [2020, p. 26] "The size of the impact on the economy varies with the size of the assumed multiplier, which is especially hard to predict in light of the uncertainty associated with the coronavirus pandemic and associated policy responses"
Leontiev [1997] Dependence between the growth of gross product and production of goods and services as a result of an increase in the intermediate consumption in a specific industry
Papikyan [2018, p. 25] "A change in the resulting indicator under the impact of an impulse indicator in absolute (relative) terms"
Multiplier
Savelyeva [2017, p. 394] "Growth of autonomous expenditure raises the income by more than the amount of initial expenditure"
Samuelson, Nordhaus [2009] A coefficient that shows the relationship between an increase in national income and an increase in any component of total spending
Eliseeva [2015, p. 207] "A linear progression coefficient that determines by how many units the value of the endogenous variable will change if the exogenous variable changes by one unit of its measurement"
Lopatnikov [2003, p. 208] "A coefficient that serves as a measure of the multiplying effect of positive feedback on the output value of the controlled system. For each "portion" of an increase in the input value, the multiplying effect has a damped nature over several cycles of the system development"
Ermakova [2006, p. 9] "A coefficient that determines the ratio between an increase (decrease) in the endogenous indicator and a one-time increase (decrease) in the exogenous indicator taking into account the multiplying effect of positive feedback"
Many foreign researchers and experts contributed to the theoretical bases and problems of organisational management, peculiarities of the long-term care system development. Some scholars define SLTC as activities undertaken by care workers aimed at delivering social services at home or in a specialised institution [Matthews, 2018; Gutterman, 2022; Kotschy, Bloom, 2022; Peace, 2022]. Other studies emphasise the delivery of services over a long period of time using assistive mobility devices (walkers, canes, wheelchairs, etc.) [Hirose, Czepulis-Rutkowska, 2016; Caffrey, Sen-gupta, Melekin, 2021; Hoyt, 2022].
Russian researchers argue that the volume of social services delivered depends on the age restrictions and health condition of the elderly people with disabilities; the care can be provided at home or in a specialised centre using family care and social patronage services [Yakovlev, Linev, 2015; Degtyarev, Degtyarev, Nagibin, 2020, p. 38; Kholostova, Kononova, 2020; Kolosova, 2021, p. 197].
The definitions presented in Table 1 do not distinguish between a direct and an indirect impact of the multiplier effect, because all of them focus on reflecting the reasons behind it. Besides, their analysis indicated a confusion of some of the concepts and an emphasis on certain types of multiplier effects.
We separate the concept "multiplier effect" from the concept "multiplier", therefore, first of all we need to give our definitions to the terms "multiplier of the development of the long-term care system (for services)" and "multiplier effect in the long-term care system".
Within this study, the said multiplier is understood as a coefficient equal to the inverse of the difference of one and the marginal propensity to spend on certain types of services. The latter is calculated as a ratio of a change in expenditure on certain type of services to a change in the volume of the state financing of the long-term care system. A multiplier in this system is used to determine the multiplier effect.
The multiplier effect in the long-term care system manifests in multiple changes (increases or decreases) in expenditure on various types of services (transport, utilities, education, communications, catering, cultural events, health resort treatment) delivered by social welfare institutions due to changes (increases or decreases) in the volume of federal and regional funding allocated for the long-term care system.
Several approaches to calculating the multiplier and evaluating the multiplier effect in individual industries are reported in the scholarly literature (Table 2).
Taking into account the existing practice of interpreting and evaluating the multiplier effect we evaluate this effect according to the Keynesian approach: based on identifying the marginal propensity of the population to consume we calculate a multiplier (coefficient), which reflects the impact of changes in government spending on consumption (sufficiency with goods and services). Keynes stated that considerable
Table 2. Advantages and disadvantages of the approaches to calculating the multiplier and evaluating the multiplier effect
Approach Advantages Disadvantages
Keynesian approach (J. M. Keynes) Calculations require data on income and spending, linear dependencies between government spending and output are determined Multiplier effects are calculated using a single formula for the entire economy, i.e., in scalar form
Intersectoral balance model (V. V. Leontiev) Multiplier effects are determined based on gross domestic product taking into account industry affiliation. This model permits to research peculiarities of changes in a tax base or pricing, as well as to analyse important economic linkages and proportions in the manufacturing industry The model allows calculating only the investment and GDP multipliers. In does not consider inter-regional trade and regional specifics, focuses only on production processes and the use of income and goods, does not reflect redistribution processes
Social accounting matrices (SAMs) (G. Pyatt) The matrix not only allows evaluating transfer payments, expenditures and incomes of the general government, household, and other sectors, but also predicting the indicators of the system of national accounts [Pyatt, Round, 1979] The official statistics needed for calculating the multiplier are not publicly available
spending of the government, business partners, or consumers positively influence national income, i.e., government investment will produce an increase in gross domestic product. In conditions of the budgetary restrictions applying this method will allow estimating how the volume of government investment into the implementation of socially important projects affects a regional economy, including related industries.
Government investment in the system of long-term care for the elderly people with disabilities produces a multiplier effect on related services industries. In turn, introduction of this system in the regions of the Russian Federation means that new jobs will be created in the institutions, which will deliver the said services (indirect effect on employment). At the same time, using caregiver services will allow relatives or legal representatives who take care of an elderly person on their own to resume work and professional activities, which will lead to an increase in household incomes. Thus, financing of the long-term care system contributes to the development of services in other areas.
The experience of Israel, Austria, the USA, and Germany confirms the presence of a multiplier effect, which manifests itself primarily in the impact of the SLTC on the labour market and specifically on workers providing social care services. The introduction of this system involves changing the working conditions and remuneration
of personnel, which significantly improves their productivity, ensures the financial security of employees and the decent quality of services provided, reduces the mortality rate, the number of physical and mental health disorders, as well as the cost of preventive care [Ruffini, 2020]. In addition, the SLTC affects such spheres as transport, catering, leisure, health care, education, culture, trade in food and household goods, pharmaceuticals, etc.1 [Weller et al., 2020; Palladino, Mabud, 2021; Chen et al., 2022].
In line with the international experience, our method for calculating the values of the multiplier (as a coefficient) of various types of services uses seven major services in related industries, which the introduction of the long-term care system affects the most (Figure 1). At the same time, we should highlight that the development of the related industries impacts on this system in terms of availability and improvement of its infrastructure, production of the necessary goods and materials. This boosts its efficiency, as well as the volume and quality of the services delivered.
Fig. 1. The influence of a long-term care system for elderly citizens on related areas
The SLTC development increases the transport infrastructure load due to transportation of immobile and low-mobility elderly citizens to health care facilities or cultural institutions, operation of a larger fleet of low-floor vehicles, development of a social taxi service, provision of special equipment for surface, elevated and underground pedestrian crossings, pedestrian paths, stopping points, as well as equipping sidewalks with ramps, etc.
Greater demand for education services is due to the importance of improving the knowledge, skills and abilities of care workers, as well as promoting their level of professional competencies related to manipulation, interpersonal interactions with
1 OECD. (2020). Long-term care and health care insurance in OECD and Other Countries. 36 p. https://www. oecd.org/daf/fin/insurance/Long-Term-Care-Health-Care-Insurance-in-OECD-and-Other-Countries.pdf.
difficult or unmotivated elderly clients, and the use of modern technical means of rehabilitation. There emerges a need to obtain additional vocational education under advanced training and retraining programmes, as well as to eliminate the inconsistency with the requirements of professional standards identified during the internal audit.
Providing long-term care services at home or in specialised centres leads to the growth in fees for housing and utilities services (hot and cold water supply, heat supply, gas and electricity supply, sanitation) and major repairs.
Demand for communications services goes up due to remote counseling on social and legal issues and the use of specialised software to synchronise data on elderly people in interdepartmental interaction.
Employees of social welfare institutions and recipients of social services generate extra demand for services in culture, leisure, outdoor activities (visits to cinemas, theaters, libraries, organisation of the concerts with the participation of elderly people with limited ability to self-care). This determines the demand for cultural and educational centres, clubs, interest groups, day care centers.
Naturally, the volume of health resort services (health restoration, rehabilitation, treatment of elderly people with limited ability to self-care, prevention of major diseases) is increasing. In the presence of medical indications, disabled and immobile elderly citizens are provided with vouchers for health resort treatment. The introduction of the care facility-replacing technology "health resort at home" allows people with disabilities to undergo a ten-day course for boosting the immunity, including inhalations, water therapy, etc.
Living in care centres increases the load on catering facilities (maintenance of high quality food and diet, which is the basis of health and longevity).
Research results
The volume of paid services for the elderly and disabled in the Russian Federation goes up steadily year by year. For instance, in 2019 it amounted to 27.4 billion rubles, and in 2020 reached 28.2 billion rubles [Deren, 2020, p. 34].
The long-term care system in Russia has been implemented since 2018 [Andryush-chenko et al, 2019, p. 58]. Initially, it was introduced in 6 pilot regions, and in 2022 it was extended to 34 regions [Samofatova, 2020, p. 51]. In 2018-2021, the number of social services' recipients in this system increased gradually (Figure 2).
According to the forecast, up until 2035, the number of recipients of long-term care services at home will be growing, while the similar indicator for specilised centres will remain stable as it depends on their capacity (Figure 3).
2018 2019 2020 2021
Number of social services' recipients in the pilot regions, thousand persons -Share of services' recipients within the SLTC in the total number of people in need,1
Fig. 2. The number of social services' recipients in the pilot regions, 2018-20211
million persons
2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035
Recipients of social services provided at home ■ Recipients of social services provided in social care centres
Fig. 3. Forecast of the number of social services' recipients at home and in specialised centres,
2023-20352
Considering the system of long-term care for the elderly as a factor behind the intensification of social services in the Russian Federation, we should focus on the multiplier effect (economic aspect) from the development of this system and on
1 Source: own calculations based on data from Passport of the federal project "Older Generation". Ministry of Labour and Social Protection of the Russian Federation. https://mintrud.gov.ru/ministry/programms/demog-raphy/3. (In Russ.); The system of the long-term care in the Russian Federation. On the approval of the standard model of the SLTC. (2020). https://timchenkofoundation.org/wp-content/uploads/2020/11/20201023-sdu-3.0-ger-iatrija.pdf. (In Russ.); On the implementation in some constituent entities of the Russian Federation of the standard model of the long-term care system for elderly citizens and disabled people in need of care in 2022: Order of the Ministry of Labour and Social Protection of the Russian Federation no. 929 of December 29, 2021. https://docs. cntd. ru/document/727973632. (In Russ.); Safonov A. Forecast of the development of the social service market in Russia. Official website of the Association of professional participants in the long-term care system. https://ltc-rus. org/conference_ltc_2021_digest. (In Russ.)
2 Source: Long-term care system in Russia. Official website of the Association of professional participants in the long-term care system. https://ltc-rus.org/sdu_russiafsolutions. (In Russ.)
identifying its direct and indirect impact on the related industries and on the sphere of social care in general.
The direct impact materialises in the contribution to gross domestic product due to paying for services, which are not provided for free. In particular, such long-term care services include services delivered with technical means of rehabilitation and modern rehabilitation equipment.
In the sphere of social care this impact manifests itself in the significant improvement of the working conditions of social care workers and caregivers and a boost in the labour productivity, as well as a reduction in labour intensity since technical means of care and rehabilitation are used. The multiplier effect also manifests itself in the indirect impact, which is wider than the direct one. This impact promotes the development of the related industries.
We calculated the values of the multiplier of the development of the system of long-term care for the elderly considering the case of services. We used the data for 2019-2022 structured by the main categories of expenses within the implementation of the said system in the pilot social welfare institutions subordinate to the Ministry of Labour and Social Protection of the Stavropol krai. These organisations include Budyonnovsky, Grachevsky, Zheleznovodsky, Krasnogvardeisky, Nev-innomyssky, Neftekumsky, Predgorny and Sovetsky integrated social care centers (ISCC), as well as Georgievsky, Izobilnensky, Kraevoy, Petrovsky social care centers (SCC) (Table 3).
Table 3. Input data for calculating the multiplier of the development of the long-term care system for elderly citizens in the Stavropol krai
Indicator Volume of expenditure, rubles
2019 2020 2021 2022
The amount of funds allocated from the federal and regional budgets for the implementation of the long-term care system (F) 32,830,508.07 59,575,601.68 117,793,674.55 132,375,901.44
Transport expenses (transportation of social services' recipients to day care groups, medical examinations by specialist doctors, screening) (Etr) 84,471.37 433,539.40 822,412.99 1,357,048.19
Utilities expenses (housing and utility bills) (Eu) 582,147.40 904,762.27 1,031,045.97 982,056.78
Educational expenses (training of personnel, including at the expense of federal funds) (Eed) 2,680,150.00 2,721,830.00 2,857,390.00 316,314.00
Table 3 (concluded)
Indicator Volume of expenditure, rubles
2019 2020 2021 2022
Communications expenses (Ecom) 75,789.00 208,033.00 253,944.00 283,759.00
Catering expenses for recipients of social services in day care groups (Ecat) 46,420.00 410,465.00 671,215.00 684,455.04
Cultural expenses (paying for the services of organising cultural events) (Ecui) 29,700.00 277,421.00 223,875.00 265,715.00
Health resort treatment expenses (vouchers, etc.) (Ehrt) 3,345,456.31 3,604,492.85 375,000.00 355,000.00
The values of the multiplier of the development of the long-term care system (for services) (M^0) for the elderly citizens in the Stavropol krai were calculated with the formula:
SLTC = -1--(D
; l-MPSfTC (1)
where MPS?00 is the marginal propensity to spend.
In our method for calculating the said multiplier, MPS^LTC corresponds to the marginal propensity to consume according to the Keynesian approach and is calculated as a ratio of a change in expenses for a particular type of services to a change in the volume of the state financing:
12
MPSr= AVA^,*...*^ (2)
1=1
where Ej is a category of expenses,; = 1^7, rubles; i is a social welfare institution, i = 1^12; F is the amount of funds allocated from the federal and the krai's budgets for the implementation of the long-term care system, rubles.
The multiplier for various types of services is calculated for each type of expenses: transport (Etr), utilities (Eu), educational (personnel training) (Eed), communications (Ecom), catering (Ecat), cultural (EcuL), health resort treatment (Ehrt) (Table 4).
The obtained data allowed estimating the impact of federal investments, as well as the investments from the krai's budget directed to the development of the long-term care system on the Stavropol krai's economy. Increases or decreases in funds for various types of services in 2019-2022 affects the results of the multiplier calculations. An
Table 4. The values of the multiplier of the development of the long-term care system
for elderly citizens in the Stavropol krai
Indicator 2020 2021 2022
A^ 26,745,093.61 58,218,072.87 14,582,226.89
Transport services
AEtn 349,068.03 388,873.59 534,635.20
MPStr 0.0162 0.0067 0.0367
Mtr 1.0165 1.0067 1.0381
Utilities services
AEui 322,614.87 126,283.70 -48,989.19
MPSU 0.0121 0.0022 -0.0034
Mu 1.0122 1.0022 0.9967
Personnel training
AEedi 41,680.00 135,560.00 -2,541,076.00
MPSed 0.0016 0.0023 -0.1743
Med 1.0016 1.0023 0.8516
Communications services
AE 132,244.00 45,911.00 29,815.00
MPSCom 0.0049 0.0008 0.0020
M lvJ-com 1.0050 1.0008 1.0020
Catering services
AEcati 364,045.00 410,465.00 13,240.04
MPScat 0.0136 0.0071 0.0009
Meat 1.0138 1.0071 1.0009
Organisation of cultural events
AEculi 247,721.00 -53,546.00 41,840.00
MPScul 0.0093 -0.0009 0.0029
Mcul 1.0093 0.9991 1.0029
Health resort treatment
AEhrti 259,036.54 -3,229,492.85 -20,000.00
MPShrt 0.0097 -0.0555 -0.0014
Mhrt 1.0098 0.9474 0.9986
Source: own calculations based on data of the pilot institutions of the Stavropol krai, which were collected from December 2022 to February 2023 using the official request for information about the main categories of expenses within the implementation of the SLTC.
increase in the funds allocated for the implementation of the long-term care system influences positively the amount of various expenses, while a decrease in the expenses leads to a decrease in the value of the multiplier.
In line with our calculations, the multiplier effect is formed as a result of an augmented demand for goods and products in the related industries: transport, housing and utilities, education, culture, communications, catering, health resort treatment.
In the pilot institutions of the Stavropol krai, the number of the provided long-term care services amounted to 3,368,545 units in 2022, which is 20 % more than in 2019 (668,244 units), while the number of recipients soared from 2,546 persons in 2019 to 11,248 persons in 2022. In connection with this, during 2019-2022 at the expense of the federal budget 312.25 positions of specialists were made available in ISCCs and SCCs. In 2022, at the expense of the federal budget these centres introduced 56 more positions of caregivers.
In 2022, compared to 2019, the total of the wages of all employees involved in the delivery of long-term care services rocketed by 129 % and amounted to 121,198,298.88 rubles.
Discussion
The values of the multiplier of the development of the long-term care system (for services) for the elderly with limited ability to self-care are presented in Figure 4.
2020
2021
Education Housing and utilities Health resort treatment Catering Communications Culture Transport
1.0016
1.0122 1.0098 1.0138
0.9900 0.9990 1.0080 1.0170 1.0260
Education Housing and utilities Health resort treatment Catering Communications Culture Transport
1.0023 1.0022
0.9474
1.0071 1.0008 0.9991 1.0067
0.9300 0.9600 0.9900 1.0200
2022
Education Housing and utilities Health resort treatment Catering Communications Culture Transport
0.8516
0.9967 0.9986 1.0009 1.0020 1.0029 1.0381
0.8300 0.8800 0.9300 0.9800 1.0300 1.0800 Fig. 4. The multipliers of the development of the long-term care system for elderly citizens
The values of the multiplier for gross output of the regional economy are greater than one for every type of services only in 2020. In this case, Keynes's ideas about the need to promote economic growth by boosting the government spending on goods and services in transport, education, housing and utilities, culture, communications, health resort treatment, catering are confirmed.
The highest value of the multiplier (1.0381) was registered in 2022 for transport services which is due to an increase in the volume of the government spending on transport services (transportation of social services' recipients to day care groups, medical examinations by specialist doctors, screening).
Average values of the multiplier are found in housing and utilities, catering, culture, communications, while decreased value of the multiplier are spotted in the spheres producing predominantly consumer goods and services (education, health resort treatment, etc.). This results from the redistribution of the federal financial resources.
The smallest value of the multiplier (0.8516) appears in 2022 for education services. These expenses (for personnel training) influence economic growth in the long run. A decrease in the corresponding value results from cutting off the funding from the federal budget. Pilot institutions should cover this need from their own funds from income-generating activities.
The introduction of the SLTC is intersectoral in nature: it also affects other related services sectors, encourages interdepartmental interaction and business activity of contractors, suppliers, service and maintenance enterprises, leading to additional demand for their goods and services. The revenues received by specialists, organisations and budgets from the functioning of the long-term care system create new consumer cycles of goods and products, which ensures economic growth due to the emerging links between economic entities in different industries. The growth in the consumption of goods and services increases the production potential and the output, while the provision of services and the manufacture of goods generate new jobs. Thus, a systematic macroeconomic process is formed, which stimulates the activity of economic entities in social production.
Conclusion
Demographic changes occurring worldwide dictate the need to explore the avenues of decent satisfaction of elderly citizens' demand for long-term care services, in particular, develop the social infrastructure objects and ensure proper personnel training.
Our method for calculating the multiplier of the development of the long-term care system (for services) was devised allowing for the basic postulates of the Keynes-ian approach. An increase in the general volume of the federal and krai's funding of
the SLTC leads to a multiple increase in expenses for various types of services: transport, utilities, education, catering, communications, culture, health resort treatment.
The testing of the developed method using the case of social care centres in the Stavropol krai confirmed the presence of the multiplier effect. This means that the financing of the SLTC allows achieving not only the goals of the pilot project to introduce this system in the territory of the Russian Federation such as ensuring quality of life and promoting longevity, maintaining the habitual lifestyle and health of social services' recipients. We also notice the multiplier effect in the transport infrastructure, which arises due to the organisation of transportation of immobile and low-mobility elderly citizens to health care facilities or cultural institutions, in education (due to the training of personnel involved in the provision of social care services who study simple manipulations, algorithms and principles of working with non-mobile and low-mobility citizens, and work out actions and manipulations in simulation zones), in housing and utilities (due to paying for utilities and major repairs), in the field of communications (advising the elderly and disables), in culture, health resort services, and public catering (due to an increase in demand for social services).
The depreciation in the values of multipliers for certain types of services is associated with a decrease in federal funding for these services. At the same time, in order to maintain the multiplier effect, it is necessary to provide for the use of the income of institutions participating in the pilot project to implement a system of long-term care for elderly people with limited ability to self-care and/or movement.
References
Degtyarev G. P., Degtyarev A. G., Nagibin O. A. (2020). Technologies and standards for long-term care for the elderly: International and Russian practice. Problemy standartizatsii v zdravookhrane-nii = Health Care Standardization Problems, no. 5 (6), pp. 37-44. DOI: 10.26347/1607250220200506037-044. (In Russ.)
Deren I. I. (2020). Economic trends in the service sector in the russian federation taking into account global factors. Vestnik Natsionalnoy akademii turizma = Vestnik of National Tourism Academy, no. 3 (55), pp. 34-37. (In Russ.)
Eliseeva I. I. (2015). Econometrics. Moscow: Yurayt Publ. 450 p. (In Russ.)
Ermakova S. Yu. (2006). Multiplier theory and multiplier effects in economics. Abstract of Cand. econ. sci. diss. Ulan-Ude. 22 p. (In Russ.)
Kolosova G. V. (2021). Institutionalization of long-term care for the elderly: the experience of Saint Petersburg. Sotsial'nye i gumanitarnye znaniya = Social and Human Knowledge, vol. 7, no. 2, pp. 194-203. DOI: 10.18255/2412-6519-2021-2-194-203. (In Russ.)
Leontiev V. V. (1997). Intersectoral economics. Moscow: Ekonomika Publ. 477 p. (In Russ.)
Lopatnikov L. I. (2003). Economic mathematical dictionary: A dictionary of contemporary economic science. Moscow: Delo Publ. 519 p. (In Russ.)
Papikyan L. M. (2018). Assessment of the multiplier impact of investment and construction projects on the development of territories. Cand. econ. sci. diss. Moscow. 243 p. (In Russ.)
Savelyeva A. S. (2017). Multiplier effect of institutions. Sovremennye nauchnye issledovaniya i razrabotki = Modern Scientific Research and Development, no. 2 (10), pp. 393-395. (In Russ.)
Samofatova K. A. (2020). Algorithm of the functioning of the system of long-term care for elderly citizens in the framework of public-private partnership. Sotsialnaya politika i sotsiologiya = Social Policy and Sociology, vol. 19, no. 4 (137), pp. 50-58. DOI: 10.17922/2071-3665-2020-19-4-5058. (In Russ.)
Kholostova E. I., Kononova L. I. (2020). Long-term care: Essence, organisation, technologies, and means of implementation. 2nd ed. Moscow: Dashkov i K Publ. 265 p. (In Russ.)
Yakovlev V. M., Linev I. V. (2015). The synergistic and multiplicative effects of public-private partnerships in the livelihoods of citizens. MIR (Modernizatsiya. Innovatsii. Razvitie) = MIR (Modernization. Innovation. Research), vol. 6, no. 3, pp. 56-61. (In Russ.)
Andryushchenko G. I., Savina M. V., Soldatov A. A., Bikbulatova A. A., Samofatova K. A. (2019). Efficiency improvement of long-term care for senior citizens in the Russian Federation. Academic Journal of Interdisciplinary Studies, vol. 8, no. 2, pp. 58-67. DOI: 10.2478/ajis-2019-0017.
Caffrey C., Sengupta M., Melekin A. (2021). Residential care community resident characteristics: United States, 2018 (NCHS Data Brief no. 404). Hyattsville, MD: National Center for Health Statistics. DOI: https://doi.org/10.15620/cdc103826.
Chen A., Fuino M., Sehner T., Wagner J. (2022). Valuation of long-term care options embedded in life annuities. Annals of Actuarial Science, vol. 16, pp. 68-94. https://doi.org/10.1017/ S1748499521000063.
Gutterman A. S. (2022). Long-term care. 55 p. http://dx.doi.org/10.2139/ssrn.3849759.
Hirose K., Czepulis-Rutkowska Z. (2016). Challenges in long-term care of the elderly in Central and Eastern Europe. Budapest: ILO. 37 p.
Hoyt J. (2022). A guide to long-term care for seniors. https://www.seniorliving.org/care/.
Kahn R. F. (1931). The relation of home investment to unemployment. The Economic Journal, vol. 41, issue 162, pp. 173-198. https://doi.org/10.2307/2223697.
Keynes J. M. (1936). The general theory of employment, interest and money. London: Macmillan (reprinted 2007). 190 p.
Kotschy R., Bloom D. (2022). A comparative perspective on long-term care systems. International Social Security Review, vol. 75, pp. 47-69. DOI:10.1111/issr.12307.
Matthews J. (2018). Long-term care: How to plan and pay for it. Berkeley, CA: NOLO. 384 p.
Palladino L. M., Mabud R. (2021). It's time to care. The economic case for investing in a care infrastructure. TIME'S UP Foundation. 28 p.
Peace S. (2022). Care home living: A form of long-term care. In: The Environments of Ageing: Space, Place and Materiality (pp. 193-234). DOI: https://doi.org/10.46692/9781447310570.010.
Pyatt G., Round J. I. (1979). Accounting and fixed price multipliers in a social accounting matrix framework. The Economic Journal, vol. 89, no. 356, pp. 850-873. https://doi.org/10.2307/2231503.
Ruffini K. (2020). Worker earnings, service quality, and firm profitability: Evidence from nursing homes andminimum wage reforms. Washington: Washington Center for Equitable Growth. Evidence for a stronger economy. 96 p.
Samuelson P., Nordhaus W. (2009). Economics. 19th ed. McGraw Hill. 744 p.
Weller C., Almeida B., Cohen M., Stone R. (2020). Making Care Work Pay. How paying at least a living wage to direct care workers could benefit care recipients, workers, and communities. LeadingAge LTSS Center. 49 p.
Information about the authors
Ivanna I. Deren, Dr. Sc. (Econ.), Associate-Prof., Prof. of Humanities and Socioeconomic Studies Dept. Vladimir Law Institute of the Federal Penitentiary Service, Vladimir, Russia. E-mail: deren-ivanna@yandex.ru
Kseniya A. Samofatova, Applicant for Candidate Degree of Strategic Planning and Management in Housing and Utilities Dept. State University of Vladimir named after Alexander and Nikolay Stoletovs, Vladimir, Russia. E-mail: kandikaeva@mail.ru
© Deren I. I., Samofatova K. A., 2023
