Different impact on health outcomes of long-term care insurance between urban and rural older residents in China

Abstract

Long-term care insurance (LTCI) is garnering attention internationally and is being considered a public policy in a growing number of countries. Previous research has focused on the effects of LTCI in developed countries, ignoring the health outcomes of developing countries, especially in rural regions. Therefore, this study investigates whether different impact on health outcomes is present in the effects of LTCI between urban and rural residents in China. We employed a quasi-experimental design with data from the China Health and Retirement Longitudinal Survey. The specific implementation time of each pilot city was sorted according to the LTCI policy texts, dividing these pilot cities into the treatment group and control group. Finally, difference-in-differences analyses were utilized to evaluate the health effects of LTCI between urban and rural residents, and the health effect in urban areas was further tested. The implementation of LTCI has effectively enhanced the self-rating health (SRH) of the entire group of residents; however, this effect may only be significant for the urban group. In particular, LTCI can increase the SRH of urban residents by 0.377 units compared to the urban residents without LTCI (P < 0.01). The result of the placebo effect test further verifies that LTCI could improve the health of residents to some extent. In China, LTCI may have triggered different impacts on health outcomes between urban and rural residents, and may not improve the SRH of rural residents and only prove efficacious for urban residents. Government and policy-makers should give more attention to the rural group as it needs long-term care the most.

The effect of long-term care insurance on healthcare utilization of middle-aged and older adults: evidence from China health and retirement longitudinal study

“…Scholars such as Xueqin Deng and Jin Feng have assessed the policy effects in a pilot city [ 20 , 21 ], and found that LTCI can effectively reduce the burden on families and healthcare. Some of the studies used publicly available databases to assess the effectiveness of LTCI, but did not accurately correspond to the provisions for the disabled population in each pilot city [ 22 ], or did not include the non-covered population in the pilot city in the control group [ 23 ]. Therefore, this paper focuses on the effect of LTCI on healthcare utilzation among disabled middle-aged and elderly people, selects appropriate data and methods for accurate analysis and substantive discussion, and explores the heterogeneity of LTCI’s policy effects across regions and different disabled populations from a health equity perspective.…”