Jin Liu, Jiaozhi Hao, Elizabeth Maitland, Stephen Nicholas, Jian Wang, Anli Leng
{"title":"中国50-70岁成人长期护理保险意向的形成：信息干预在健康风险中的作用","authors":"Jin Liu, Jiaozhi Hao, Elizabeth Maitland, Stephen Nicholas, Jian Wang, Anli Leng","doi":"10.1093/geroni/igaf054","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>China's population aging, especially increasing numbers of older people with disability and dementia, challenges the public health care system. Long-term care insurance (LTCI) is essential to provide care for China's fast-growing aging population, yet there is a lack of evidence on how the health risks of disability and dementia influence the acceptance of LTCI in China. This study explores the effects of health risk information about disability or dementia on the LTCI intentions of the Chinese aged 50-70.</p><p><strong>Research design and methods: </strong>Using stratified random sampling and convenience sampling methods, we designed a survey of 1 025 respondents aged 50-70 from 8 provinces in China. We randomly assigned respondents to control (<i>n</i> = 354), disability risk (<i>n</i> = 339), and dementia risk (<i>n</i> = 332) groups, and used multinomial logit models to investigate the information intervention effects on respondents' different LTCI (No/Uncertain/Yes) intentions. Also, we analyzed the heterogeneity of respondents' education level and whether living in LTCI pilot/nonpilot policy cities.</p><p><strong>Results: </strong>Both disability and dementia risk information significantly decreased the probability that respondents were unwilling relative to being willing to enroll in LTCI. The marginal prediction results show that pretest LTCI intentions played a key role in shaping postintention LTCI. In the analysis of heterogeneity, we found that disability information was associated with an increased likelihood of respondents with lower levels of education answering \"uncertain,\" and dementia information was associated with a decreased likelihood of answering \"no\" for respondents living in the LTCI pilot policy cities.</p><p><strong>Discussion and implications: </strong>Disability and dementia risk interventions significantly improved LTCI intentions among Chinese aged 50-70. To improve the acceptance of LTCI, we recommend that policymakers adopt the strategies of information interventions for LTCI policy advocacy and differentiate dementia-related and disability-related risk information by individuals with different educational levels and residents in LTCI pilot/nonpilot policy cities.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 6","pages":"igaf054"},"PeriodicalIF":4.3000,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365492/pdf/","citationCount":"0","resultStr":"{\"title\":\"Shaping Long-term Care Insurance Intentions Among Chinese Adults Aged 50-70: Role of Information Interventions in Health Risks.\",\"authors\":\"Jin Liu, Jiaozhi Hao, Elizabeth Maitland, Stephen Nicholas, Jian Wang, Anli Leng\",\"doi\":\"10.1093/geroni/igaf054\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>China's population aging, especially increasing numbers of older people with disability and dementia, challenges the public health care system. Long-term care insurance (LTCI) is essential to provide care for China's fast-growing aging population, yet there is a lack of evidence on how the health risks of disability and dementia influence the acceptance of LTCI in China. This study explores the effects of health risk information about disability or dementia on the LTCI intentions of the Chinese aged 50-70.</p><p><strong>Research design and methods: </strong>Using stratified random sampling and convenience sampling methods, we designed a survey of 1 025 respondents aged 50-70 from 8 provinces in China. We randomly assigned respondents to control (<i>n</i> = 354), disability risk (<i>n</i> = 339), and dementia risk (<i>n</i> = 332) groups, and used multinomial logit models to investigate the information intervention effects on respondents' different LTCI (No/Uncertain/Yes) intentions. Also, we analyzed the heterogeneity of respondents' education level and whether living in LTCI pilot/nonpilot policy cities.</p><p><strong>Results: </strong>Both disability and dementia risk information significantly decreased the probability that respondents were unwilling relative to being willing to enroll in LTCI. The marginal prediction results show that pretest LTCI intentions played a key role in shaping postintention LTCI. In the analysis of heterogeneity, we found that disability information was associated with an increased likelihood of respondents with lower levels of education answering \\\"uncertain,\\\" and dementia information was associated with a decreased likelihood of answering \\\"no\\\" for respondents living in the LTCI pilot policy cities.</p><p><strong>Discussion and implications: </strong>Disability and dementia risk interventions significantly improved LTCI intentions among Chinese aged 50-70. To improve the acceptance of LTCI, we recommend that policymakers adopt the strategies of information interventions for LTCI policy advocacy and differentiate dementia-related and disability-related risk information by individuals with different educational levels and residents in LTCI pilot/nonpilot policy cities.</p>\",\"PeriodicalId\":13596,\"journal\":{\"name\":\"Innovation in Aging\",\"volume\":\"9 6\",\"pages\":\"igaf054\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-05-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365492/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Innovation in Aging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/geroni/igaf054\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Innovation in Aging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/geroni/igaf054","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Shaping Long-term Care Insurance Intentions Among Chinese Adults Aged 50-70: Role of Information Interventions in Health Risks.
Background and objectives: China's population aging, especially increasing numbers of older people with disability and dementia, challenges the public health care system. Long-term care insurance (LTCI) is essential to provide care for China's fast-growing aging population, yet there is a lack of evidence on how the health risks of disability and dementia influence the acceptance of LTCI in China. This study explores the effects of health risk information about disability or dementia on the LTCI intentions of the Chinese aged 50-70.
Research design and methods: Using stratified random sampling and convenience sampling methods, we designed a survey of 1 025 respondents aged 50-70 from 8 provinces in China. We randomly assigned respondents to control (n = 354), disability risk (n = 339), and dementia risk (n = 332) groups, and used multinomial logit models to investigate the information intervention effects on respondents' different LTCI (No/Uncertain/Yes) intentions. Also, we analyzed the heterogeneity of respondents' education level and whether living in LTCI pilot/nonpilot policy cities.
Results: Both disability and dementia risk information significantly decreased the probability that respondents were unwilling relative to being willing to enroll in LTCI. The marginal prediction results show that pretest LTCI intentions played a key role in shaping postintention LTCI. In the analysis of heterogeneity, we found that disability information was associated with an increased likelihood of respondents with lower levels of education answering "uncertain," and dementia information was associated with a decreased likelihood of answering "no" for respondents living in the LTCI pilot policy cities.
Discussion and implications: Disability and dementia risk interventions significantly improved LTCI intentions among Chinese aged 50-70. To improve the acceptance of LTCI, we recommend that policymakers adopt the strategies of information interventions for LTCI policy advocacy and differentiate dementia-related and disability-related risk information by individuals with different educational levels and residents in LTCI pilot/nonpilot policy cities.
期刊介绍：
Innovation in Aging, an interdisciplinary Open Access journal of the Gerontological Society of America (GSA), is dedicated to publishing innovative, conceptually robust, and methodologically rigorous research focused on aging and the life course. The journal aims to present studies with the potential to significantly enhance the health, functionality, and overall well-being of older adults by translating scientific insights into practical applications. Research published in the journal spans a variety of settings, including community, clinical, and laboratory contexts, with a clear emphasis on issues that are directly pertinent to aging and the dynamics of life over time. The content of the journal mirrors the diverse research interests of GSA members and encompasses a range of study types. These include the validation of new conceptual or theoretical models, assessments of factors impacting the health and well-being of older adults, evaluations of interventions and policies, the implementation of groundbreaking research methodologies, interdisciplinary research that adapts concepts and methods from other fields to aging studies, and the use of modeling and simulations to understand factors and processes influencing aging outcomes. The journal welcomes contributions from scholars across various disciplines, such as technology, engineering, architecture, economics, business, law, political science, public policy, education, public health, social and psychological sciences, biomedical and health sciences, and the humanities and arts, reflecting a holistic approach to advancing knowledge in gerontology.
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