Home or institution: A comparative analysis of elderly care efficacy in China

IF 2.9 3区经济学 Q1 ECONOMICS

Journal of Asian Economics Pub Date : 2025-02-22 DOI:10.1016/j.asieco.2025.101894

Chunfeng Zhang, Xiaoyan Lei

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Abstract

Institutional care and home-based care represent two fundamental components of elderly care systems across Asian countries. This study leverages the exogenous shock induced by the Long-Term Care Insurance (LTCI) pilot program in China to comparatively assess the efficacy of institutional versus home-based care. The analysis reveals that, relative to home-based care, institutional care more effectively addresses the caregiving needs of the elderly and enhances their access to medical services. However, it also entails higher caregiving costs and may contribute to negative outcomes, such as accelerated cognitive decline, deterioration in instrumental activities of daily living (IADL), and impaired vision, although it does not appear to increase short-term mortality risk. Further investigation suggests that these adverse effects may be linked to limited social engagement and reduced daily activities within institutional settings. These results underscore the critical need for care systems to address not only the basic care and medical requirements of the elderly but also their higher-level needs to improve their overall well-being.

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家庭还是机构：中国老年人护理效果的比较分析

机构护理和家庭护理是亚洲国家老年人护理系统的两个基本组成部分。本研究利用中国长期护理保险（LTCI）试点项目引发的外生冲击，比较评估机构和家庭护理的效果。分析显示，相对于以家庭为基础的照料，机构照料更有效地解决了老年人的照料需求，并增加了他们获得医疗服务的机会。然而，它也需要更高的护理成本，并可能导致负面结果，如认知能力加速下降、日常生活工具活动（IADL）恶化和视力受损，尽管它似乎不会增加短期死亡风险。进一步的调查表明，这些不利影响可能与机构环境中社会参与有限和日常活动减少有关。这些结果强调了护理系统的迫切需要，不仅要解决老年人的基本护理和医疗需求，还要解决他们提高整体福祉的更高层次需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Asian Economics ECONOMICS-

CiteScore

4.70

自引率

9.40%

发文量

期刊介绍： The Journal of Asian Economics provides a forum for publication of increasingly growing research in Asian economic studies and a unique forum for continental Asian economic studies with focus on (i) special studies in adaptive innovation paradigms in Asian economic regimes, (ii) studies relative to unique dimensions of Asian economic development paradigm, as they are investigated by researchers, (iii) comparative studies of development paradigms in other developing continents, Latin America and Africa, (iv) the emerging new pattern of comparative advantages between Asian countries and the United States and North America.