Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China

Jin, Feng; Wang, Zhen; Yu, Yan

doi:10.1016/j.socscimed.2020.113081

Cited by 87 publications

(79 citation statements)

References 19 publications

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“…Moreover, a sounding health infrastructure cannot live without sustainable financial schemes. In this regard, China has made promising progresses for both urban and rural populations (Hsiao 1995, Feng et al 2020, Gao et al 2014. Another solution, as emphasised by Bloom et al (2010a), is to encourage behavioural adjustments.…”

Section: Further Robustness Checksmentioning

confidence: 99%

“…Moreover, large elderly cohorts have led to increased incidence rates of chronic diseases (i.e. cardiovascular diseases, cancer, chronic renal disease, diabetes and their respective complications) and higher demand of long-term healthcare services including expensive technologies and hospitalisation which has put the sustainability of healthcare systems at risk (Fujino 1987;Murthy and Ukpolo 1994;Feng et al 2020). On the other hand, greater health expenditure leads to increased availability of medical products and long-term healthcare services with a parallel rise of longevity (Kunze 2014).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effects of ageing population on health expenditure and economic growth in China: A Bayesian-VAR approach

Lopreite

Zhu

2020

Social Science & Medicine

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Section: Further Robustness Checksmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effects of ageing population on health expenditure and economic growth in China: A Bayesian-VAR approach

Lopreite

Zhu

2020

Social Science & Medicine

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“…Thirdly, the social and economic impact of public LTCI on population aging is enormous. Firstly, The physical health of the beneficiaries of the public LTCI has improved significantly, especially those receiving (Feng et al 2020). Finally, LTCI system has experienced different degrees of difficulties and challenges in the development process of different countries, which will affect the long-term The literature review of this paper gives us some policy implications.…”

Section: Discussionmentioning

confidence: 99%

Review of evolution of the public long-term care insurance (LTCI) system in different countries: influence and challenge

Chen

Zhang

2020

BMC Health Serv Res

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Background The growing demand for LTC (Long-term care) services for disabled elderly has become a daunting task for countries worldwide, especially China, where population aging is particularly severe. According to CSY (China Statistical Yearbook,2019), the elderly aged 65 or above has reached 167 million in 2018, and the number of disabled elderly is as high as 54%. Germany and other countries have alleviated the crisis by promoting the public LTCI (Long-Term Care Insurance) system since the 1990s, while China’s public LTCI system formal pilot only started in 2016. Therefore, the development of the public LTCI system has gradually become a hot topic for scholars in various countries, including China. Methods This review has been systematically sorted the existing related literature to discuss the development of public LTCI (Long-Term Care Insurance)system form four aspects, namely, the comparison of public LTCI systems in different countries, the influence of public LTCI, challenge of public LTCI, and the relationship between public LTCI and private LTCI. We searched some databases including Web of Science Core Collection, Medline, SCOPUS, EBSCO, EMBASE, ProQuest and PubMed from January 2008 to September 2020. The quality of 38 quantitative and 21 qualitative articles was evaluated using the CASP(Critical Appraisal Skills Programme) critical evaluation checklist. Results The review systematically examines the development of public LTCI system from four aspects, namely, the comparison of public LTCI systems in different countries, the influence of public LTCI, the challenge of public LTCI, and the relationship between public LTCI and private LTCI. For example, LTCI has a positive effect on the health and life quality of the disabled elderly. However, the role of LTCI in alleviating the financial burden on families with the disabled elderly may be limited. Conclusion Some policy implications on the future development of China’s LTCI system can be obtained. For example, the government should fully consider the constraints such as price rise, the elderly disability rate, and the substantial economic burden. It also can strengthen the effective combination of public LTCI and private LTCI. It does not only help to expand the space for its theoretical research but also to learn the experiences in the practice of the LTCI system in various countries around the world. It will significantly help the smooth development and further promote the in-depth reform of the LTCI system in China.

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“…CNKI=China National Knowledge Infrastructure Based on these comprehensive criteria, six studies which all used regression analysis and had a sample size less than 10,000 participants were rated low evidence quality, including Qi et al ( 2019), 37 Zhang et al (2020), 39 Zhang et al ( 2019), 40 Chen et al (2020), 41 Dai et al ( 2019), 42 and Zhang (2019). 43 Two studies, Feng et al (2020) 36 and Ma et al (2019), 38 were classified as having medium evidence quality as they utilized a difference-in-differences design and had a sample size greater than 10,000 participants. Only Yu et al (2020), 35 a randomized controlled trial, was classified as having high evidence quality.…”

Section: Figure 1 Systematic Review Study Selection Flow Diagrammentioning

confidence: 99%

The impact of long-term care insurance in China on beneficiaries and caregivers: A systematic review

Chen

Yang

et al. 2021

Journal of Global Health Economics and Policy

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Background China’s long-term care insurance (LTCI) policy has been minimally evaluated. This systematic review aimed to assess the impact of China’s LTCI pilot on beneficiaries and their caregivers. Methods This review is based on a search of peer-reviewed studies in English (Embase, MEDLINE, Web of Science) and Chinese (China National Knowledge Infrastructure [CNKI], VIP, Wanfang) databases from January 2016 through July 2020, with all studies published in English or Chinese included. We included quantitative analyses of beneficiary-level data that assessed the impact of LTCI on beneficiaries and their caregivers, with no restriction placed on the outcomes studied. Results Nine studies met our inclusion criteria. One study was a randomised trial and two used quasi-experimental approaches. Four studies examined LTCI’s effect on beneficiaries’ quality of life, physical pain, and health service utilisation; one study reported the effect on beneficiaries’ healthcare expenditures; and one study evaluated the impact on caregivers’ care tasks. These studies generally found LTCI to be associated with an improvement in patients’ quality of life (including decreased physical pain), a reduction in the number of outpatient visits and hospitalisations, decreased patient-level health expenditures (e.g. one study reported a reduction in the length of stay, inpatient expenditures, and health insurance expenditures in tertiary hospitals by 41.0%, 17.7%, and 11.4%, respectively), and reduced informal care tasks for caregivers. In addition, four out of four studies that evaluated this outcome found that beneficiaries’ overall satisfaction with LTCI was high. Conclusion The current evidence base for the effects of LTCI in China on beneficiaries and their caregivers is sparse. Nonetheless, the existing studies suggest that LTCI has positive effects on beneficiaries and their caregivers. Further rigorous research on the impacts of LTCI in China is needed to inform the future expansion of the program.

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Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China

Cited by 87 publications

References 19 publications

The effects of ageing population on health expenditure and economic growth in China: A Bayesian-VAR approach

The effects of ageing population on health expenditure and economic growth in China: A Bayesian-VAR approach

Review of evolution of the public long-term care insurance (LTCI) system in different countries: influence and challenge

The impact of long-term care insurance in China on beneficiaries and caregivers: A systematic review

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