Evaluating the long-term care insurance policy from medical expenses and health security equity perspective: evidence from China

Liu, Huan; Hu, Tiantian

doi:10.1186/s13690-021-00761-7

Cited by 24 publications

(20 citation statements)

References 32 publications

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“…In this study, the three-period data from CHARLS in 2011, 2015, and 2018 were utilized to evaluate the health effects of LTCI on older residents within the triple difference framework. The empirical results demonstrated that the implementation of LTCI in China could effectively improve the SRH of older residents, which is consistent with the conclusion of a previous study 39 . Further analysis after separating the urban and rural samples illustrated that LTCI could only improve the SRH of urban older residents effectively and had no impact on older rural residents.…”

Section: Discussionsupporting

confidence: 90%

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

Liu

Yang

et al. 2023

Sci Rep

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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.

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Section: Discussionsupporting

confidence: 90%

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

Liu

Yang

et al. 2023

Sci Rep

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“…However, the existing health production function does not consider the impact of the natural environment or air quality. Therefore, this study used individual ADL disability as a proxy for health variables and assumed that ADL disability is influenced by sociodemographic, regional environmental and individual health characteristics [ 45 ]. Here, sociodemographic characteristics include gender, age, household-registered marital status, etc.…”

Section: Methodsmentioning

confidence: 99%

Determining the effect of air quality on activities of daily living disability: using tracking survey data from 122 cities in China

Liu

2022

BMC Public Health

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Background Current research on activities of daily living (ADLs) disability has mostly focused on the analysis of demographic characteristics, while research on the microcharacteristics of individuals and the macroenvironment is relatively limited, and these studies solely concern the impact of air quality on individual health. Methods This study innovatively investigated the impact of air quality on ADL disability by matching micro data of individuals from the China Health and Retirement Longitudinal Study with data of urban environmental quality from 122 cities. In this study, an ordered panel logit model was adopted for the benchmark test, and the two-stage ordered probit model with IV was used for endogenous treatment. Results This innovative study investigated the impact of air quality on ADL disability by matching individual micro data from the China Health and Retirement Longitudinal Study with urban environmental quality data for 122 cities. The results showed that air quality significantly increased the probability of ADL disability. The positive and marginal effect of air quality on moderate and mild disability was higher. Generally, the marginal effect of air quality on residents’ health was negative. In terms of group heterogeneity, the ADL disability of individuals aged over 60 years, those in the high Gross Domestic Product (GDP) group, females, and those in the nonpilot long-term care insurance group was more affected by air quality, and the interaction between air quality and serious illness showed that the deterioration of air quality exacerbated the ADL disability caused by serious illness; that is, the moderating effect was significant. Conclusions According to the equilibrium condition of the individual health production function, the ADL disability caused by a 1% improvement in air quality is equivalent to the ADL disability caused by an 89.9652% reduction in serious illness, indicating that the effect of improved air quality is difficult to replace by any other method. Therefore, good air quality can not only reduce ADL disability directly but also reduce serious illness indirectly, which is equivalent to the reduction of ADL disability. This is called the health impact.

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“…As for China, many scholars also paid attention to this topic. Based on the China Health and Retirement Longitudinal Study (CHARLS) database in 2013, 2015 and 2018, Liu and Hu ( 23 ) assessed the impact of the long-term care policy pilot on residents' medical expenses and found that the policy significantly reduced the outpatient, inpatient and average daily hospitalization expenses of the elderly. Using the medical expenses data of internal and surgical inpatients of a hospital in Beijing from June 2016 to December 2019, Xiao et al ( 24 ) conducted a regression discontinuity design (RDD) to test the impact of the comprehensive reform of separation of medicine and pharmacy and the comprehensive reform of medical consumption linkage on residents' medical expenses, and the results showed that the two reforms significantly reduced the proportion of drugs and medical consumption.…”

Section: Literature Reviewmentioning

confidence: 99%

The impact of national comprehensive medical reform on residents' medical expenses: Evidence from China

Nie

Yuan

2023

Front. Public Health

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Residents' high medical expenses is the core challenge that needs to be solved urgently in China's medical reform for a long time. Based on the panel data of 30 provinces in Chinese Mainland during 2011–2019, we evaluate the impact of China's national comprehensive medical reform pilot policy on residents' medical expenses by using the difference-in-differences model. The results show that the pilot policy was generally conducive to reducing residents' medical expenses, resulting in a reduction of 2.13% in per capita medical expenses for inpatients, but the effect on per capita medical expenses for outpatients was insignificant. Mechanism analysis shows that hospital competition and institutional environment played a moderating role in the effect of the pilot policy on residents' medical expenses reduction. The more intense the hospital competition and the better the institutional environment, the more significant of the reduction effect. In addition, the reduction effect of the pilot policy was greater in the central provinces, the provinces with poor medical infrastructure, and the provinces with strong financial strength. This study provides useful policy insights for deepening medical reform and reducing residents' medical expenses.

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Evaluating the long-term care insurance policy from medical expenses and health security equity perspective: evidence from China

Cited by 24 publications

References 32 publications

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

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

Determining the effect of air quality on activities of daily living disability: using tracking survey data from 122 cities in China

The impact of national comprehensive medical reform on residents' medical expenses: Evidence from China

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