Research on long-term care insurance: status quo and directions for future research

Eling, Martin; Ghavibazoo, Omid

doi:10.1057/s41288-018-00114-6

Cited by 29 publications

(23 citation statements)

References 138 publications

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“…At present, the research abroad has an early start in which theoretical research and empirical studies have achieved fruitful results. Previous studies mainly focused on the financing model (9, 10), equity (11), and sustainability of financing (12), advantages and disadvantages of public and private LTCI financing (13,14), and comparison of financing mechanisms (15)(16)(17). The quantitative studies on the financing mechanism of LTCI have a wide range of contents and mature methods.…”

Section: Previous Researchmentioning

confidence: 99%

Research on Financing Mechanism of Long-Term Care Insurance in Xiamen, China: A System Dynamics Simulation

Zhang

Fang

2021

Front. Public Health

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Objective: This study aimed to predict the changing trend of long-term care insurance (LTCI) funds by clarifying the linkage between revenue and expenditure and its influencing factors and to provide evidence for the establishment of a sustainable LTCI financing mechanism in China.Method: We have taken Xiamen as an example, based on the data from Xiamen Special Economic Zone Yearbook and field survey. The changing trend of LTCI funds is predicted from 2020 to 2030 based on the system dynamics model (SDM) of the LTCI financing system. Also, through literature research and expert consultation, we found the intervention goals and analyzed their impact on the balance of LTCI funds.Results: In the current situation, according to the forecast, the revenue and the expenditure of the LTCI funds will increase year by year from 2020 to 2030 in Xiamen, an increase of about 3.7 times and 8.8 times, respectively. After 2029, the expenditure will exceed the revenue of the LTCI funds and the balance will turn into a deficit. From the perspective of fund revenue, by adjusting the individual payment rate, government financial subsidies, and enterprise payment rate, the proportion of LTCI funds can be increased to alleviate the balance deficit under the original forecast. On the contrary, from the perspective of fund expenditure, increasing the proportion of reimbursement and the rate of severe disability will lead to an increase in fund expenditure. In this case, the balance of the funds will turn into a deficit, 7 years in advance. In addition, it was found that the severe disability rate has the greatest impact on the balance of funds.Discussion: The SDM can objectively reflect the structure and the behavior of the LTCI financing system and has good applicability. By increasing the individual payment rate, government financial subsidies, and enterprise contribution rate, reasonable setting of the reimbursement ratio of nursing services, especially for the prevention of disability among the elderly, to maintain the sustainability of the funds. This study provides strong evidence for policymakers to establish a sustainable LTCI system in China.

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Section: Previous Researchmentioning

confidence: 99%

Research on Financing Mechanism of Long-Term Care Insurance in Xiamen, China: A System Dynamics Simulation

Zhang

Fang

2021

Front. Public Health

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“…Reviewing the financing of long-term care globally, two third of the financing is done through taxes and out-of-pocket payments; the remaining third of the financing is organized in social security systems such as those implemented in Japan or Germany. 3 These tend to be pay-as-you-go systems, meaning that today's working generation finances the costs of today's beneficiaries. An alternative to this redistribution from current workers to beneficiaries might be a capitalfunded scheme where the population accumulates assets for their own future risk.…”

Section: A Global Reviewmentioning

confidence: 99%

“…10 The out-of-pocket payments personal contributions of those in need of care already account for a high proportion of total financing in Switzerland compared with other countries (30%, while the average internationally is only 13.5%). 3 If this status quo is maintained, the financial burden on those in need of care and on the municipals will reach the limits of feasibility. Accordingly, the sustainability of long-term care financing is not given, which has resulted in several recent political discussions.…”

Section: The Situation In Switzerlandmentioning

confidence: 99%

Financing Long-term Care: Some Ideas From Switzerland Comment on "Financing Long-term Care: Lessons From Japan"

Eling

2019

Int J Health Policy Manag

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Ikegami reviews the implementation of mandatory long-term care insurance systems in Germany and Japan, which are organized as pay-as-you-go systems. I propose to go one step further and implement a multi-pillar, mandatory and voluntary long-term care financing system, which combines pay-as-you-go with capital-funded elements. The proposal is based on the observation that Switzerland has implemented a three-pillar system for financing retirement provisions that can be adapted to finance long-term care in a fair and sustainable way.

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“…While the first type relates to care received upon request, the latter corresponds to 24-h supervision in a specialized infrastructure including accommodation and comes at higher costs. Three major questions arise from LTC [37]. First, the threat of a financial burden stems from the importance of these costs.…”

Section: Introductionmentioning

confidence: 99%

On the characteristics of reporting ADL limitations and formal LTC usage across Europe

2020

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The increase in the proportion of elderly people in most industrialized countries triggers higher demand for long-term care (LTC) associated with limitations in activities of daily living (ADL). The aim of this research is to derive the drivers affecting the probability of reporting limitations in ADL and the probability of demanding formal LTC, e.g., personal care and services in domestic tasks. By using the most recent wave of a cross-national European survey on individuals aged over 50 years (SHARE, wave 6), we develop econometric models for identifying the effect of demographic, social and medical factors on ADL limitations and formal LTC along five conjectures. On the one hand, we analyze functional limitations and we find that characteristics such as the age, the gender, the wealth status and the education level influence the probability to report limitations. Further, while we find that pathologies significantly increase the probability to become dependent in general, the effect of cancer is lower. On the other hand, we find again an influence of the demographic and social factors on the probability to use formal LTC. We emphasize on the decrease in the probability due to the presence of the partner in the household, in particular for housekeeping tasks. This is less the case for help related with personal care. In addition, we note that pathologies such as cancer have no influence on the probability to report formal LTC while others like mental and Parkinson diseases highly increase it. We find that elderly living in countries with LTC family care schemes report less formal care than in others. This indicates the importance of LTC policies. Finally, we validate the robustness of our results by applying the models to data from earlier waves of the survey. Our findings give insights for the underwriting standards to be used in future LTC insurance products and for the design of LTC policy environments across Europe.

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Research on long-term care insurance: status quo and directions for future research

Cited by 29 publications

References 138 publications

Research on Financing Mechanism of Long-Term Care Insurance in Xiamen, China: A System Dynamics Simulation

Research on Financing Mechanism of Long-Term Care Insurance in Xiamen, China: A System Dynamics Simulation

Financing Long-term Care: Some Ideas From Switzerland Comment on "Financing Long-term Care: Lessons From Japan"

On the characteristics of reporting ADL limitations and formal LTC usage across Europe

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