IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v296y2022ics027795362200048x.html
   My bibliography  Save this article

Long-term care insurance and the well-being of older adults and their families: Evidence from China

Author

Listed:
  • Lei, Xiaoyan
  • Bai, Chen
  • Hong, Jingpeng
  • Liu, Hong

Abstract

This paper examines the impact of China's public long-term care insurance (LTCI) pilots on the well-being of older adults and their families. Using panel data from the Chinese Longitudinal Healthy Longevity Survey, we exploit the rollout of the LTCI pilots across different cities during 2015–2017 and identify the effect of LTCI using a difference-in-differences approach. We find that the implementation of LTCI has reduced the likelihood of older adults reporting unmet activity of daily living (ADL)–related need for care, the intensity of informal care, and the amounts of ADL-related care expenditures and out-of-pocket medical expenditures. LTCI coverage was also associated with an improvement in self-reported health and a reduction in one-year mortality risk of older adults with baseline need for care. From a policy perspective, these findings suggest that the introduction of LTCI may benefit all members of the household, both care recipient and caregivers, which has important implications for the development of LTCI in China and other middle-income and developing countries.

Suggested Citation

  • Lei, Xiaoyan & Bai, Chen & Hong, Jingpeng & Liu, Hong, 2022. "Long-term care insurance and the well-being of older adults and their families: Evidence from China," Social Science & Medicine, Elsevier, vol. 296(C).
  • Handle: RePEc:eee:socmed:v:296:y:2022:i:c:s027795362200048x
    DOI: 10.1016/j.socscimed.2022.114745
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S027795362200048X
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2022.114745?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Chandoevwit, Worawan & Wasi, Nada, 2020. "Incorporating discrete choice experiments into policy decisions: Case of designing public long-term care insurance," Social Science & Medicine, Elsevier, vol. 258(C).
    2. García-Gómez, Pilar & Hernández-Quevedo, Cristina & Jiménez-Rubio, Dolores & Oliva-Moreno, Juan, 2015. "Inequity in long-term care use and unmet need: Two sides of the same coin," Journal of Health Economics, Elsevier, vol. 39(C), pages 147-158.
    3. Chen, Lu & Fan, Hongli & Chu, Lanlan, 2019. "The hidden cost of informal care: An empirical study on female caregivers' subjective well-being," Social Science & Medicine, Elsevier, vol. 224(C), pages 85-93.
    4. Liliana E. Pezzin & Peter Kemper & James Reschovsky, 1996. "Does Publicly Provided Home Care Substitute for Family Care? Experimental Evidence with Endogenous Living Arrangements," Journal of Human Resources, University of Wisconsin Press, vol. 31(3), pages 650-676.
    5. Manuela Angelucci & Giacomo De Giorgi, 2009. "Indirect Effects of an Aid Program: How Do Cash Transfers Affect Ineligibles' Consumption?," American Economic Review, American Economic Association, vol. 99(1), pages 486-508, March.
    6. Haushofer, Johannes & Chemin, Matthieu & Jang, Chaning & Abraham, Justin, 2020. "Economic and psychological effects of health insurance and cash transfers: Evidence from a randomized experiment in Kenya," Journal of Development Economics, Elsevier, vol. 144(C).
    7. Rhee, Jong Chul & Done, Nicolae & Anderson, Gerard F., 2015. "Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany," Health Policy, Elsevier, vol. 119(10), pages 1319-1329.
    8. Orsini, Chiara, 2010. "Changing the way the elderly live: Evidence from the home health care market in the United States," Journal of Public Economics, Elsevier, vol. 94(1-2), pages 142-152, February.
    9. Wei Huang & Chuanchuan Zhang, 2021. "The Power of Social Pensions: Evidence from China's New Rural Pension Scheme," American Economic Journal: Applied Economics, American Economic Association, vol. 13(2), pages 179-205, April.
    10. Guido W. Imbens & Jeffrey M. Wooldridge, 2009. "Recent Developments in the Econometrics of Program Evaluation," Journal of Economic Literature, American Economic Association, vol. 47(1), pages 5-86, March.
    11. Kim, Hyuncheol Bryant & Lim, Wilfredo, 2015. "Long-term care insurance, informal care, and medical expenditures," Journal of Public Economics, Elsevier, vol. 125(C), pages 128-142.
    12. Elena Glinskaya & Zhanlian Feng, 2018. "Options for Aged Care in China," World Bank Publications - Books, The World Bank Group, number 29807, December.
    13. Fu, Rong & Noguchi, Haruko & Kawamura, Akira & Takahashi, Hideto & Tamiya, Nanako, 2017. "Spillover effect of Japanese long-term care insurance as an employment promotion policy for family caregivers," Journal of Health Economics, Elsevier, vol. 56(C), pages 103-112.
    14. McKnight, Robin, 2006. "Home care reimbursement, long-term care utilization, and health outcomes," Journal of Public Economics, Elsevier, vol. 90(1-2), pages 293-323, January.
    15. Feng, Jin & Wang, Zhen & Yu, Yangyang, 2020. "Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China," Social Science & Medicine, Elsevier, vol. 258(C).
    16. Stabile, Mark & Laporte, Audrey & Coyte, Peter C., 2006. "Household responses to public home care programs," Journal of Health Economics, Elsevier, vol. 25(4), pages 674-701, July.
    17. Chang, Shuang & Yang, Wei & Deguchi, Hiroshi, 2020. "Care providers, access to care, and the Long-term Care Nursing Insurance in China: An agent-based simulation," Social Science & Medicine, Elsevier, vol. 244(C).
    18. Lu, Bei & Mi, Hong & Yan, Gaoyun & Lim, Jonathan K.H. & Feng, Guanggang, 2020. "Substitutional effect of long-term care to hospital inpatient care?," China Economic Review, Elsevier, vol. 62(C).
    19. Sohn, Minsung & O'Campo, Patricia & Muntaner, Carles & Chung, Haejoo & Choi, Mankyu, 2020. "Has the long-term care insurance resolved disparities in mortality for older Koreans? examination of service type and income level," Social Science & Medicine, Elsevier, vol. 247(C).
    20. Zhu, Yumei & Österle, August, 2017. "Rural-urban disparities in unmet long-term care needs in China: The role of the hukou status," Social Science & Medicine, Elsevier, vol. 191(C), pages 30-37.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Liu, Hong & Ma, Jinqiu & Zhao, Liqiu, 2023. "Public long-term care insurance and consumption of elderly households: Evidence from China," Journal of Health Economics, Elsevier, vol. 90(C).
    2. Ding, Xiangyuan & Yuan, Luoqi & Zhou, Yi, 2023. "Internet access and older adults' health: Evidence from China," China Economic Review, Elsevier, vol. 82(C).
    3. Masaki Takahashi, 2023. "Insurance coverage, long-term care utilization, and health outcomes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(8), pages 1383-1397, November.
    4. Luo, Yanan & Yuan, Kexin & Li, Yuxiao & Liu, Yating & Pan, Yao, 2024. "The “spillover effect” of long-term care insurance in China on spouses’ health and well-being," Social Science & Medicine, Elsevier, vol. 340(C).
    5. Wang, Mingzhe & Huang, Hai & Xiong, Jie & Yuan, Zhe & Zeng, Keya, 2023. "Impact of ecological reserves on the local residents’ health: Evidence from a natural experiment in China," Social Science & Medicine, Elsevier, vol. 336(C).
    6. Hollingsworth, Bruce & Ohinata, Asako & Picchio, Matteo & Walker, Ian, 2022. "Does It Matter Who Cares for You? The Effect of Substituting Informal with Formal Personal Care on the Care Recipients' Health," IZA Discussion Papers 15457, Institute of Labor Economics (IZA).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Liu, Hong & Ma, Jinqiu & Zhao, Liqiu, 2023. "Public long-term care insurance and consumption of elderly households: Evidence from China," Journal of Health Economics, Elsevier, vol. 90(C).
    2. Luo, Yanan & Yuan, Kexin & Li, Yuxiao & Liu, Yating & Pan, Yao, 2024. "The “spillover effect” of long-term care insurance in China on spouses’ health and well-being," Social Science & Medicine, Elsevier, vol. 340(C).
    3. Hollingsworth, Bruce & Ohinata, Asako & Picchio, Matteo & Walker, Ian, 2022. "Does It Matter Who Cares for You? The Effect of Substituting Informal with Formal Personal Care on the Care Recipients' Health," IZA Discussion Papers 15457, Institute of Labor Economics (IZA).
    4. Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    5. Liu, Yinan & Zai, Xianhua, 2022. "The Unintended Effect of Medicaid Aging Waivers on Informal Caregiving," EconStor Preprints 249566, ZBW - Leibniz Information Centre for Economics.
    6. Yinan Liu & Emma Zai, 2023. "The unintended effect of Medicaid aging waivers on informal caregiving," MPIDR Working Papers WP-2023-006, Max Planck Institute for Demographic Research, Rostock, Germany.
    7. Costa-Font, Joan & Jiménez-Martín, Sergi & Vilaplana-Prieto, Cristina, 2022. "Do Public Caregiving Subsidies and Supports affect the Provision of Care and Transfers?," Journal of Health Economics, Elsevier, vol. 84(C).
    8. Judite Gonçalves & France Weaver, 2017. "Effects of formal home care on hospitalizations and doctor visits," International Journal of Health Economics and Management, Springer, vol. 17(2), pages 203-233, June.
    9. Guangbo Ma & Kun Xu, 2022. "Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health," IJERPH, MDPI, vol. 20(1), pages 1-20, December.
    10. Orsini, Chiara, 2010. "Changing the way the elderly live: Evidence from the home health care market in the United States," Journal of Public Economics, Elsevier, vol. 94(1-2), pages 142-152, February.
    11. Sano, Kazuaki & Miyawaki, Atsushi & Abe, Kazuhiro & Jin, Xueying & Watanabe, Taeko & Tamiya, Nanako & Kobayashi, Yasuki, 2022. "Effects of cost sharing on long-term care service utilization among home-dwelling older adults in Japan," Health Policy, Elsevier, vol. 126(12), pages 1310-1316.
    12. Nicolas R. Ziebarth, 2018. "Social Insurance and Health," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 57-84, Emerald Group Publishing Limited.
    13. Kang, Lili & Zhao, Guangchuan, 2022. "Financial support for unmet need for personal assistance with daily activities: Implications from China's long-term care insurance pilots," Finance Research Letters, Elsevier, vol. 45(C).
    14. Hollingsworth, Bruce & Ohinata, Asako & Picchio, Matteo & Walker, Ian, 2017. "Labour Supply and Informal Care Supply: The Impacts of Financial Support for Long-Term Elderly Care," IZA Discussion Papers 10988, Institute of Labor Economics (IZA).
    15. Huimin Zhang & Xiaoyi Zhang & Youhua Zhao & Jianfeng Huang & Wenwei Liu, 2020. "Impact of Formal Care Use on Informal Care from Children after the Launch of Long-Term Care Insurance in Shanghai, China," IJERPH, MDPI, vol. 17(8), pages 1-10, April.
    16. Huan Liu, 2021. "Formal and Informal Care: Complementary or Substitutes in Care for Elderly People? Empirical Evidence From China," SAGE Open, , vol. 11(2), pages 21582440211, May.
    17. Loken, Katrine Vellesen & Lundberg, Shelly & Riise, Julie, 2014. "Lifting the Burden: State Care of the Elderly and Labor Supply of Adult Children," IZA Discussion Papers 8267, Institute of Labor Economics (IZA).
    18. Feng, Jin & Wang, Zhen & Yu, Yangyang, 2020. "Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China," Social Science & Medicine, Elsevier, vol. 258(C).
    19. Rellstab, Sara & Bakx, Pieter & García-Gómez, Pilar & van Doorslaer, Eddy, 2020. "The kids are alright - labour market effects of unexpected parental hospitalisations in the Netherlands," Journal of Health Economics, Elsevier, vol. 69(C).
    20. Elena Gentili & Giuliano Masiero & Fabrizio Mazzonna, 2016. "The Role of Culture in Long-term Care," IdEP Economic Papers 1605, USI Università della Svizzera italiana.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:296:y:2022:i:c:s027795362200048x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.