{"title":"Cash-Out Puzzle and Long-Term Care Insurance: Welfare of the Elderly.","authors":"Xiaoyan Lei, Chunfeng Zhang","doi":"10.1002/hec.4935","DOIUrl":null,"url":null,"abstract":"<p><p>This study investigates the effects of diverse payment methods within long-term care insurance (LTCI) on the well-being of elderly individuals, encompassing both in-kind and cash payments. Utilizing panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we leverage a generalized difference-in-differences (DID) approach and the LTCI pilots across various Chinese cities to identify the impacts of different LTCI payment methods. Our findings indicate that an in-kind LTCI policy significantly decreases the one-year mortality of older adults, with significant improvements on ADL-related care receipt as well as health status. Conversely, no significant impacts are observed under the framework of a cash LTCI policy. We term the weaker effects regarding older adults in cash LTCI policy versus in-kind LTCI policy as \"the cash-out puzzle\". Our findings emphasize the critical importance of developing right incentives of LTCI payment schemes thoughtfully worldwide.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health economics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/hec.4935","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
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Abstract
This study investigates the effects of diverse payment methods within long-term care insurance (LTCI) on the well-being of elderly individuals, encompassing both in-kind and cash payments. Utilizing panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we leverage a generalized difference-in-differences (DID) approach and the LTCI pilots across various Chinese cities to identify the impacts of different LTCI payment methods. Our findings indicate that an in-kind LTCI policy significantly decreases the one-year mortality of older adults, with significant improvements on ADL-related care receipt as well as health status. Conversely, no significant impacts are observed under the framework of a cash LTCI policy. We term the weaker effects regarding older adults in cash LTCI policy versus in-kind LTCI policy as "the cash-out puzzle". Our findings emphasize the critical importance of developing right incentives of LTCI payment schemes thoughtfully worldwide.
期刊介绍：
This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems.
Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses.
Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.
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