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

Abstract

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.

The operational experience of private owners of small-sized care homes in China: a qualitative study

“…However, the combination of rapid socioeconomic change, an ageing population, the one-child policy and other demographic shifts, is eroding the ability and capacity of the family-based system to care for the older population in China [ 4 ]. Moreover, long-term care costs for older people are not currently covered by national healthcare insurance schemes [ 5 ] and only older people without children are eligible for places in government-funded public care homes [ 6 ]. Although some aged care insurance pilot programmes have been implemented in several cities from 2016, studies have since found that such programmes are often fragmented in their coverage, eligibility, funding and reimbursement [ 4 , 5 ].…”

“…Moreover, long-term care costs for older people are not currently covered by national healthcare insurance schemes [ 5 ] and only older people without children are eligible for places in government-funded public care homes [ 6 ]. Although some aged care insurance pilot programmes have been implemented in several cities from 2016, studies have since found that such programmes are often fragmented in their coverage, eligibility, funding and reimbursement [ 4 , 5 ].…”

Long-term care insurance, mental health of the elderly and its spillovers

“…In addition to the reduction in financial burdens, Lei et al (18) further found that LTCI improves older people's selfreported health and reduces their mortality risks. However, these studies mainly focus on only one pilot city (13,32). The study on China's LTCI is still not enough, especially the limitation on older adults' mental health and spillover effects.…”

Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health

“…Testing for a potential placebo effect was necessary to rule out the effects of other exogenous events (such as healthcare reform measures like the critical illness insurance program) and confirm that the findings were the result of LTCI. Drawing on the work of relevant scholars [71,72], we took 1000 random samples to represent the two study groups, and the specific kernel density distribution results are shown in Figure 5. Most of the absolute values of the estimated coefficients of sampling "t-values" were within the value of 2, and the "p-values" were above 0.1.…”