The impact of long-term care insurance in China on beneficiaries and caregivers: A systematic review.

Journal of global health economics and policy Pub Date : 2021-01-01 Epub Date: 2021-11-16 DOI:10.52872/001c.29559
Simiao Chen, Linye Li, Juntao Yang, Lirui Jiao, Todd Golden, Zhuoran Wang, Haitao Liu, Peixin Wu, Till Bärnighausen, Pascal Geldsetzer, Chen Wang
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Abstract

Background: China's long-term care insurance (LTCI) policy has been minimally evaluated. This systematic review aimed to assess the impact of China's LTCI pilot on beneficiaries and their caregivers.

Methods: This review is based on a search of peer-reviewed studies in English (Embase, MEDLINE, Web of Science) and Chinese (China National Knowledge Infrastructure [CNKI], VIP, Wanfang) databases from January 2016 through July 2020, with all studies published in English or Chinese included. We included quantitative analyses of beneficiary-level data that assessed the impact of LTCI on beneficiaries and their caregivers, with no restriction placed on the outcomes studied.

Results: Nine studies met our inclusion criteria. One study was a randomised trial and two used quasi-experimental approaches. Four studies examined LTCI's effect on beneficiaries' quality of life, physical pain, and health service utilisation; one study reported the effect on beneficiaries' healthcare expenditures; and one study evaluated the impact on caregivers' care tasks. These studies generally found LTCI to be associated with an improvement in patients' quality of life (including decreased physical pain), a reduction in the number of outpatient visits and hospitalisations, decreased patient-level health expenditures (e.g. one study reported a reduction in the length of stay, inpatient expenditures, and health insurance expenditures in tertiary hospitals by 41.0%, 17.7%, and 11.4%, respectively), and reduced informal care tasks for caregivers. In addition, four out of four studies that evaluated this outcome found that beneficiaries' overall satisfaction with LTCI was high.

Conclusion: The current evidence base for the effects of LTCI in China on beneficiaries and their caregivers is sparse. Nonetheless, the existing studies suggest that LTCI has positive effects on beneficiaries and their caregivers. Further rigorous research on the impacts of LTCI in China is needed to inform the future expansion of the program.

Abstract Image

中国长期护理保险对受益人和护理人员的影响:系统综述。
背景:中国的长期护理保险(LTCI)政策很少得到评估。本系统综述旨在评估中国长期护理保险试点对受益人及其护理人员的影响:本综述基于对 2016 年 1 月至 2020 年 7 月期间英文(Embase、MEDLINE、Web of Science)和中文(中国国家知识基础设施 [CNKI]、VIP、万方)数据库中同行评议研究的检索,纳入了所有以英文或中文发表的研究。我们纳入了受益人层面的定量分析数据,这些数据评估了长期护理保险对受益人及其护理人员的影响,对研究结果没有限制:九项研究符合我们的纳入标准。其中一项研究是随机试验,两项研究采用了准实验方法。四项研究探讨了长期护理保险对受益人生活质量、身体疼痛和医疗服务利用率的影响;一项研究报告了对受益人医疗支出的影响;一项研究评估了对护理人员护理任务的影响。这些研究普遍发现,长期护理保险与患者生活质量的改善(包括身体疼痛的减轻)、门诊次数和住院次数的减少、患者医疗支出的减少(例如,一项研究报告称,患者在三级医院的住院时间、住院支出和医疗保险支出分别减少了 41.0%、17.7% 和 11.4%)以及护理人员非正式护理任务的减少有关。此外,在对这一结果进行评估的四项研究中,有四项发现受益人对长期护理保险的总体满意度很高:目前,有关中国长期护理保险对受益人及其护理人员影响的证据基础还很薄弱。尽管如此,现有研究表明,长期护理保险对受益人及其护理人员具有积极影响。有必要对中国的长期护理保险的影响进行进一步的严格研究,为今后扩大该计划提供依据。
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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