Evaluating the impact of long-term care insurance reform on health-related quality of life and inequality among older adults in China: A quasi-experimental analysis

IF 2.2 3区医学 Q2 ECONOMICS

Economics & Human Biology Pub Date : 2025-05-31 DOI:10.1016/j.ehb.2025.101495

Lin Lin , Min He , Xianhua Zai

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引用次数: 0

Abstract

Less is known about whether and to what extent Long-Term Care Insurance (LTCI) promotes the Health-Related Quality of Life (HRQoL) of older individuals, a vital health outcome for healthy aging. This study utilizes longitudinal data from CHARLS and employs the widely-used EQ-5D-3L method to measure HRQoL. Using the LTCI pilot-which has been implemented in a staggered manner since 2012-as a quasi-experiment, we apply a difference-in-differences approach and find that LTCI increases the HRQoL of older adults aged 60 and older by 1.5%–2% and those aged 70+ by 3.3%. These results suggest that the public LTCI reform in China enhances the HRQoL for the older individuals but only to a relatively modest degree. This minor improvement in HRQoL is primarily driven by increased utilization of formal care, reduced financial strain due to decreased medical expenses, and increased psychological well-being. However, we also find that the current LTCI reform, which mainly targets urban employees and residents, inadvertently exacerbates the urban-rural disparity in HRQoL of older adults.

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评估长期护理保险改革对中国老年人健康相关生活质量和不平等的影响：一项准实验分析

长期护理保险（LTCI）是否以及在多大程度上促进老年人的健康相关生活质量（HRQoL），这是健康老龄化的重要健康结果，我们对这一点知之甚少。本研究利用CHARLS的纵向数据，采用广泛使用的EQ-5D-3L方法测量HRQoL。使用自2012年以来以交错方式实施的LTCI试点作为准实验，我们采用差异中的差异方法，发现LTCI使60岁及以上老年人的HRQoL增加1.5%-2%，70岁以上老年人的HRQoL增加3.3%。这些结果表明，中国公共LTCI改革提高了老年人的HRQoL，但程度相对有限。HRQoL的轻微改善主要是由于正规护理的使用率增加，医疗费用减少导致的财务压力减轻，以及心理健康程度的提高。然而，我们也发现当前主要针对城镇职工和居民的LTCI改革无意间加剧了老年人HRQoL的城乡差距。

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

Economics & Human Biology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.50

自引率

12.00%

发文量

审稿时长

61 days

期刊介绍： Economics and Human Biology is devoted to the exploration of the effect of socio-economic processes on human beings as biological organisms. Research covered in this (quarterly) interdisciplinary journal is not bound by temporal or geographic limitations.