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However, the relative benefits to the care recipient of who provides the care are largely unknown. A person's use of formal and family care is affected by factors that also may affect their outcomes, complicating the estimation of any causal relationship. Using the 2002\u20132018 Health and Retirement Study (HRS), we examine three types of home\u2010based care combinations: family only, formal only, and both formal and family care. We use an instrumental variables strategy, using family structure as instruments for both formal care and the combination of formal and family care, to estimate the plausibly causal impact of the care provider on self\u2010reported mental and physical health outcomes. We find that, once the endogeneity of the care provider is accounted for, having both formal and family care leads to better self\u2010rated health, mobility and lower depression compared to people receiving family care only. Receiving formal care only does not affect care recipient outcomes compared to receiving family care only. These results are robust to several sensitivity analyses, including different instrument specifications, subsamples of care recipients that do not have a spouse\/partner, among women care recipients, and changing the timing of the measurement of the outcomes. These findings are important to consider as we strive to best meet the growing demand for person\u2010centered, high\u2010quality long\u2010term care in the least restrictive setting possible.<\/jats:p>","DOI":"10.1002\/hec.4972","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T05:00:39Z","timestamp":1745902839000},"page":"1487-1506","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Home\u2010Based Care Outcomes: Does the Care Provider Matter?"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1228-0938","authenticated-orcid":false,"given":"Norma B.","family":"Coe","sequence":"first","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"National Bureau of Economic Research (NBER)  Cambridge Massachusetts USA"},{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuxuan","family":"Sun","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0783-1611","authenticated-orcid":false,"given":"Courtney H.","family":"Van Houtven","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine and Duke\u2010Margolis Center for Health Policy  Durham North Carolina USA"},{"name":"The Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) Durham Veterans Affairs Health Care System,  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5200-2054","authenticated-orcid":false,"given":"Anirban","family":"Basu","sequence":"additional","affiliation":[{"name":"National Bureau of Economic Research (NBER)  Cambridge Massachusetts USA"},{"name":"School of Pharmacy University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3016-1318","authenticated-orcid":false,"given":"R. Tamara","family":"Konetzka","sequence":"additional","affiliation":[{"name":"University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Administration on Aging.2012.A Profile of Older Americans: 2012.https:\/\/acl.gov\/sites\/default\/files\/Aging%20and%20Disability%20in%20America\/2012profile.pdf."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3233\/jad\u2010161205"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2307\/j.ctvcm4j72"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu108"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2015.10.008"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2004.05.007"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.3647"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0144686X21001999"},{"key":"e_1_2_10_10_1","unstructured":"Bayoumi A. 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