Substitutional effect of long-term care to hospital inpatient care?

Lu, Bei; Mi, Hong; Yan, Gaoyun; Lim, Jonathan; Feng, Guanggang

doi:10.1016/j.chieco.2020.101466

Cited by 15 publications

(5 citation statements)

References 13 publications

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“…This study found that the implementation of the LTCI significantly reduced the annual inpatient visits and expenses, which is consistent with the findings in previous studies [6,9,11]. This implied that the LTCI played a role in reducing the medical care usage and expenses and the burden of the social medical facilities.…”

Section: Discussionsupporting

confidence: 92%

“…Lu et al (2017) found that the LTCI system will greatly relieve the pressure on hospitals caused by aging patients and systematically distribute medical resources in the long run. To sum it up, the implementation of LTCI led to a reduction in costs to all stakeholders, including the government-subsidized medical insurance and the individual [11].…”

Section: Literature Reviewmentioning

confidence: 99%

“…Currently, many studies evaluate the policy effect of the LTCI in China from different perspectives, taking some pilot cities as a case study. Most studies took Shanghai [6,9,10] and Qingdao as case studies [11][12][13][14], mainly because Qingdao was the first city in China to implement the LTCI, and Shanghai was the most aging city in China [15]. Additionally, LTCI-related data of Shanghai and Qingdao are available, which has attracted the attention of researchers.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Long-Term Care Insurance on Medical Utilization and Expenditures: Evidence from Jingmen, China

Deng

Liao

Peng

2022

IJERPH

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The purpose of this study was to evaluate the impact of long-term care insurance (LTCI) on medical utilization and expenditures in Jingmen, a pilot city of China. The propensity score matching-difference in difference (PSM-DID) approach was employed to examine the expenses and frequency of inpatient and outpatient services before and after the implementation of the LTCI based on the 2015–2018 panel data from the China Health and Retirement Longitudinal Study (CHARLS). The results showed that the annual expenditure and frequency of the inpatient services of Jingmen residents were reduced by 1923 Yuan (287.0 USD) and 0.24 times, respectively. The impact of the LTCI varied between urban and rural areas. The annual expenditure and frequency of inpatient services in rural areas were reduced by 1600 Yuan (238.8 USD) and 0.30 times, which were lower than those (3400 Yuan (507.5 USD) and 0.20 times) in urban areas. The monthly outpatient expenses and frequency in rural areas were reduced by 300 Yuan (44.8 USD) and 0.14 times, but increased by 555 Yuan (82.8 USD) and 0.07 times in urban area. The findings indicated that the implementation of the LTCI can reduce the medical utilization and expenses, and it had a greater effect in rural areas than in urban areas. It is suggested to promote the LTCI nationwide, and more policy preference should be given to the development of the LTCI in rural areas.

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Section: Discussionsupporting

confidence: 92%

Section: Literature Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Impact of Long-Term Care Insurance on Medical Utilization and Expenditures: Evidence from Jingmen, China

Deng

Liao

Peng

2022

IJERPH

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“…First, the introduction of LTCI significantly reduces medical and healthcare expenditures for elderly households while significantly boosting non-medical health care and total household expenditures. This evidence suggests that LTCI effectively covers the cost of required LTC services and reduces out-of-pocket payments, consistent with Lu (2020) finding that the LTCI pilot in Qingdao reduced residents' health insurance expenditures and out-of-pocket healthcare costs by 7,918 RMB and 2,324 RMB, respectively (Lu et al, 2020). LTCI programs often include health management and preventive care services that help older adults maintain better health, thereby reducing routine healthcare expenditures.…”

Section: Discussionsupporting

confidence: 69%

The Impact of Long-Term Care Insurance on Household Expenditures of the Elderly: Evidence from China

Hu,

Zhang,

Zhang

et al. 2024

Preprint

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This study aims to investigate the impact of China’s long-term care insurance (LTCI) pilot on household expenditures of the elderly. Utilizing the China Health and Retirement Longitudinal Study (CHARLS) 2015–2020 three-period longitudinal panel data, we examine the policy effects of LTCI using the Differences-in-Differences(DID) approach. The results indicate that the implementation of LTCI significantly reduces medical (p < 0.05) and healthcare expenditures (p < 0.05) for elderly households, while substantially increasing non-medical healthcare expenditures (p < 0.01) and total expenditures (p < 0.01). This effect is more pronounced for older households in rural areas or with lower levels of education. Furthermore, the improvement in household expenditures is strongly associated with the health status of the elderly and intergenerational economic support. These findings provide empirical evidence that LTCI enhances household expenditures and the quality of life for the elderly, which is crucial for the development of LTCI in China and other middle-income developing countries.

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“…Studies in developed countries such as the Germany, Japan and Korea found that LTCI signi cantly affected bene ciaries'health conditions, medical expenses and utilization, satisfaction, and caregivers' informal care burdens [7,8,9]. Similarly, early data from China showed that it contributes to a reduction in the burden of family care and medical expenditures [10,11,12] and an improvement in the health outcomes of older adults with home care [10]. However, as economic development proceeds and the aging population expands, traditional family informal care offered by relatives is far from meeting the multilevel care needs of the current older disabled population in China [13,14].…”

Section: Introductionmentioning

confidence: 99%

Health Value of China’s Long-term Care Insurance in Older Disabled People: Role of Institutional Care

Zhou

Zhu

Yan

et al. 2022

Preprint

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BackgroundSince the public long-term care insurance (LTCI) system was piloted in Chengdu, China in July 2017, there has been a considerable growth of LTC institutions in China. This study aimed to evaluate the health value effect of LTCI in older patients with severe disabilities in an LTC institution.MethodsThis study was based on data from 985 severe disability patients with or without LTCI from July 2017 to October 2020 in the Eighth People's Hospital, Chengdu, China. The Cox proportional hazard model estimated LTCI’s health value, including survival probability and risk of pneumonia/pressure ulcers. Subgroup analysis was performed for sex, age, Charlson Comorbidity Index (CCI), and the number of drugs.OutcomeIn the analysis 519 and 466 patients in LTCI and non-LTCI groups, respectively, were included. In adjusted Cox analyses, the LTCI group had a significantly elevated survival rate compared at 12 months (P<0.001, OR=1.758, 95% CI 1.300-2.376). At 40 months, the adjusted survival rate was 62.6% in the LTCI group, which was significantly higher (53.7%; P=0.003, OR=1.438, 95% CI 1.131-1.831). The subgroups of patients aged 60 to 79 years (interaction P=0.007) and CCI≥3 (interaction P=0.026) were more significantly associated with survival improvement than those aged >80 years and CCI< 3. The LTCI group was also at lower risk for hospital-acquired pneumonia (P=0.016, HR 0.622, 95% CI 0.422-0.917) and pressure ulcers (P=0.008, HR 0.695, 95% CI 0.376-0.862). The improved survival of LTCI remained stable in sensitivity analyses.ConclusionFor older patients with severe disabilities, in a long-term care institution, LTCI significantly improved their health profile and longevity after a year, suggesting the large role and development potentiality of institution care in the LTCI system of China.

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Substitutional effect of long-term care to hospital inpatient care?

Cited by 15 publications

References 13 publications

The Impact of Long-Term Care Insurance on Medical Utilization and Expenditures: Evidence from Jingmen, China

The Impact of Long-Term Care Insurance on Medical Utilization and Expenditures: Evidence from Jingmen, China

The Impact of Long-Term Care Insurance on Household Expenditures of the Elderly: Evidence from China

Health Value of China’s Long-term Care Insurance in Older Disabled People: Role of Institutional Care

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