Top

Published in:

Open Access 01-12-2023 | Care | Research

Does long-term care insurance reduce the disability among middle-aged and older adults? Evidence from China

Authors: Na Cao, Tong Shi, Chaoping Pan

Published in: BMC Public Health | Issue 1/2023

Abstract

This study aimed to examine whether the implementation of Long-Term Care Insurance (LTCI) policy could reduce the disability among middle-aged and older adults in China, and to test the heterogeneity of the effects. Data came from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). The Difference-In-Differences (DID) method and the panel data fixed effect model were used to estimate the effect of implementation of LTCI policy on disability among individuals aged 45 years and above. The LTCI policy had a positive impact on reducing disability among middle-aged and older people. Females, younger adults, city dwellers, and individuals living alone benefited the most from LTCI policy. The results provided empirical evidence for the implementation of LTCI policy in China and other similar countries as China. The implementation of LTCI policy should also pay more attention to inequity of the effects on reducing disability among different demographic groups.

Available only for authorised users

Wolf DA, Freedman VA, Ondrich JI, Seplaki CL, Spillman BC. Disability trajectories at the end of life: a “Countdown” Model. Journals of Gerontology Series B-Psychological Sciences and Social Sciences. 2015;70(5):745–52.CrossRefPubMedPubMedCentral

Botoseneanu A, Allore HG, de Leon CFM, Gahbauer EA, Gill TM. Sex differences in concomitant trajectories of self-reported disability and measured physical capacity in older adults. Journals of Gerontology Series a-Biological Sciences and Medical Sciences. 2016;71(8):1056–62.CrossRefPubMedPubMedCentral

McMichael AJ, McKee M, Shkolnikov V, Valkonen T. Mortality trends and setbacks: global convergence or divergence? Lancet. 2004;363(9415):1155–9.CrossRefPubMed

Feng J, Wang Z, Yu Y. Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China. Soc Sci Med 2020, 258.

Wang S, Marquez P, Langenbrunner J. Toward a healthy and harmonious life in China: stemming the rising tide of non-communicable diseases. Washington (DC): World Bank; 2011.

Jotheeswaran AT. China country assessment report on ageing and health. Switzerland: WHO; 2016.

Zheng X, Pang L, Chen G, Huang C, Liu L, Zhang L. Challenge of population aging on health. Berlin, Germany: Springer; 2016.CrossRef

Guidance on Pilot Cities to Launch. Long-Term Care Insurance.

Chen L, Zhang L, Xu X. Review of evolution of the public long-term care insurance (LTCI) system in different countries: influence and challenge. BMC Health Serv Res. 2020;20(1):1057.CrossRefPubMedPubMedCentral

10.

Verbrugge LM, Jette AM. The disablement process. Soc Sci Med. 1994;38(1):1–14.CrossRefPubMed

11.

Lane NE, Boyd CM, Stukel TA, Wodchis WP. Operationalizing the disablement process for research on older adults: a critical review. Can J Aging-Revue Canadienne Du Vieillissement. 2020;39(4):600–13.CrossRef

12.

Wang Q, Zhou Y, Ding X, Ying X. Demand for long-term Care Insurance in China. Int J Environ Res Public Health 2017, 15(1).

13.

Wang Q, Abiiro GA, Yang J, Li P, De Allegri M. Preferences for long-term care insurance in China: results from a discrete choice experiment. Soc Sci Med. 2021;281:114104.CrossRefPubMed

14.

Xu X, Chen L. Projection of long-term care costs in China, 2020–2050: based on the bayesian quantile regression method. 2019, 11(13):3530.

15.

Jeon B, Kwon S. Health and Long-Term Care Systems for older people in the Republic of Korea: Policy Challenges and Lessons. Health Syst Reform. 2017;3(3):214–23.CrossRefPubMed

16.

Lei XY, Bai C, Hong JP, Liu H. Long-term care insurance and the well-being of older adults and their families: evidence from China. Soc Sci Med 2022, 296.

17.

Feng J, Wang Z, Yu YY. Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China. Soc Sci Med 2020, 258.

18.

Fan HL, Wang YC, Gao JY, Peng ZX, Coyte PC. The Effect of a long-term Care Insurance Program on Subjective Well-Being of older adults with a Disability: quasi-experimental evidence from China. J Appl Gerontol. 2023;42(3):438–46.CrossRefPubMed

19.

Choi JK, Joung E. The association between the utilization of long-term care services and mortality in elderly Koreans. Arch Gerontol Geriatr. 2016;65:122–7.CrossRefPubMed

20.

Ishibashi T, Ikegami N. Should the provision of home help services be contained?: validation of the new preventive care policy in Japan. BMC Health Serv Res 2010, 10.

21.

Tamiya N, Noguchi H, Nishi A, Reich MR, Ikegami N, Hashimoto H, Shibuya K, Kawachi I, Campbell JC. Japan: Universal Health Care at 50 years 4 Population ageing and wellbeing: lessons from Japan’s long-term care insurance policy. Lancet. 2011;378(9797):1183–92.CrossRefPubMed

22.

Kim HB, Lim W. Long-term care insurance, informal care, and medical expenditures. J Public Econ. 2015;125:128–42.CrossRef

23.

Olivares-Tirado P, Tamiya N, Kashiwagi M. Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan. BMC Health Serv Res 2012, 12.

24.

Chen L, Xu X. Effect evaluation of the long-term Care Insurance (LTCI) System on the Health Care of the Elderly: a review. J Multidisciplinary Healthc. 2020;13:863–75.CrossRef

25.

Tsai Y. Social security income and the utilization of home care: evidence from the social security notch. J Health Econ. 2015;43:45–55.CrossRefPubMedPubMedCentral

26.

Zhang Z, Wang J, Jin M, Li M, Zhou L, Jing F, Chen K. Can medical insurance coverage reduce disparities of income in elderly patients requiring long-term care? The case of the People’s Republic of China. Clin Interv Aging. 2014;9:771–7.PubMedPubMedCentral

27.

Imai H, Fujii Y, Fukuda Y, Nakao H, Yahata Y. Health-related quality of life and beneficiaries of long-term care insurance in Japan. Health Policy. 2008;85(3):349–55.CrossRefPubMed

28.

Zhao Y, Strauss J, Chen X, Wang Y, Gong J, Meng Q, Wang G, Wang H. China Health and Retirement Longitudinal Study Wave 4 User’s Guide. In.: National School of Development, Peking University; 2020.

29.

Pan C, Kelifa MO, Liang J, Wang P. Joint trajectories of disability and related factors among older adults in China. Public Health. 2021;199:96–102.CrossRefPubMed

30.

Fauth EB, Zarit SH, Malmberg B, Johansson B. Physical, cognitive, and psychosocial variables from the disablement process model predict patterns of independence and the transition into disability for the oldest-old. Gerontologist. 2007;47(5):613–24.CrossRefPubMed

31.

Gayman MD, Turner RJ, Cui M. Physical limitations and depressive symptoms: exploring the nature of the association. Journals of Gerontology Series B-Psychological Sciences and Social Sciences. 2008;63(4):219–S228.CrossRef

32.

Hajek A, Brettschneider C, Mallon T, van der Leeden C, Mamone S, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, et al. How does social support affect functional impairment in late life? Findings of a multicenter prospective cohort study in Germany. Age Ageing. 2017;46(5):813–20.CrossRefPubMed

33.

Saito T, Murata C, Aida J, Kondo K. Cohort study on living arrangements of older men and women and risk for basic activities of daily living disability: findings from the AGES project. BMC Geriatr 2017, 17.

34.

Fisher KR, Shang XY, Li ZG. Absent role of the state: analysis of Social Support to older people with disabilities in Rural China. Social Policy & Administration. 2011;45(6):633–48.CrossRef

35.

Zhu YM, Osterle A. Rural-urban disparities in unmet long-term care needs in. China: the role of the hukou status. Soc Sci Med. 2017;191:30–7.CrossRefPubMed

36.

Smith KV, Goldman N. Measuring Health Status: Self-, interviewer, and Physician reports of overall health. J Aging Health. 2011;23(2):242–66.CrossRefPubMed

Title: Does long-term care insurance reduce the disability among middle-aged and older adults? Evidence from China
Authors: Na Cao
Tong Shi
Chaoping Pan
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Care
Published in: BMC Public Health / Issue 1/2023
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-023-16057-0

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Does long-term care insurance reduce the disability among middle-aged and older adults? Evidence from China

Abstract

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2023

Impact of COVID-19 Disease Control Committee (CDCC) policies on prevention of the disease using Bayes network inference in west of Iran

Mailing human papillomavirus self-sampling kits to women under-screened for cervical cancer improved detection in cervical cancer screening in a general population study in Japan

Explaining variance in self-efficacy among adolescents: the association between mastery experiences, social support, and self-efficacy

Labour market attachment dynamics in patients with concussion: a Danish nationwide register-based cohort study

Protocol of a cluster randomised trial of BodyKind: a school-based body image programme for adolescents

Gender differences in the association of individual and contextual socioeconomic status with hypertension in 230 Latin American cities from the SALURBAL study: a multilevel analysis