IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v340y2024ics0277953623008444.html
   My bibliography  Save this article

The “spillover effect” of long-term care insurance in China on spouses’ health and well-being

Author

Listed:
  • Luo, Yanan
  • Yuan, Kexin
  • Li, Yuxiao
  • Liu, Yating
  • Pan, Yao

Abstract

This study examined the spillover effect of long-term care insurance (LTCI) on the health outcomes and well-being of spouses for Chinese middle and old-aged adults with expected LTC demand or actual care burdens. Using panel data from the China Health and Retirement Longitudinal Study between 2011 and 2018, we investigated the impact of the introduction of LTCI pilots across several cities on old individuals by using the difference-in-differences (DID) approach. We found a spillover effect of LTCI on the health and well-being outcomes of spouses of middle and old-aged individuals with functional limitations. It might due to the fact that LTCI could relieve economic burden by reducing out-of-pocket medical expenditures, which further affects health and well-being of spouses. The spillover effect on health and well-being was found to be stronger for male spouses and low-educated spouses. Spouses of the individuals aged below 80 years old and those live without adult children were more likely to benefit from the introduction of LTCI. Moreover, providing combination benefits seems to make spouses better off than offering direct services. Therefore, the results implied that the expansion of LTCI not only helped the care recipients themselves but could also improve the health and well-being of the spouses of functionally impaired older adults.

Suggested Citation

  • 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).
    • Handle: RePEc:eee:socmed:v:340:y:2024:i:c:s0277953623008444
    DOI: 10.1016/j.socscimed.2023.116487
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953623008444
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2023.116487?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. Petra Moser & Alessandra Voena & Fabian Waldinger, 2014. "German Jewish ?migr?s and US Invention," American Economic Review, American Economic Association, vol. 104(10), pages 3222-3255, October.
    2. Mazzonna, Fabrizio, 2014. "The long-lasting effects of family background: A European cross-country comparison," Economics of Education Review, Elsevier, vol. 40(C), pages 25-42.
    3. Chen, Xi & Wang, Tianyu & Busch, Susan H., 2019. "Does money relieve depression? Evidence from social pension expansions in China," Social Science & Medicine, Elsevier, vol. 220(C), pages 411-420.
    4. Costa-Font, Joan & Jimenez-Martin, Sergi & Vilaplana, Cristina, 2018. "Does long-term care subsidization reduce hospital admissions and utilization?," Journal of Health Economics, Elsevier, vol. 58(C), pages 43-66.
    5. Rose Rubin & Shelley White-Means, 2009. "Informal Caregiving: Dilemmas of Sandwiched Caregivers," Journal of Family and Economic Issues, Springer, vol. 30(3), pages 252-267, September.
    6. Pan, Yao, 2020. "Late-life cognition: Do childhood conditions play any role?," China Economic Review, Elsevier, vol. 63(C).
    7. Feldstein, Martin, 1995. "The Effect of Marginal Tax Rates on Taxable Income: A Panel Study of the 1986 Tax Reform Act," Journal of Political Economy, University of Chicago Press, vol. 103(3), pages 551-572, June.
    8. 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.
    9. Jonathan Gruber & James M. Poterba, 1993. "Tax Incentives and the Decision to Purchase Health Insurance: Evidence from the Self-Employed," NBER Working Papers 4435, National Bureau of Economic Research, Inc.
    10. 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).
    11. 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.
    12. Ross, Catherine E. & Mirowsky, John, 2006. "Sex differences in the effect of education on depression: Resource multiplication or resource substitution?," Social Science & Medicine, Elsevier, vol. 63(5), pages 1400-1413, September.
    13. Feldstein, Martin, 1995. "The Effect of Marginal Tax Rates on Taxable Income: A Panel Study of the 1986 Tax Reform Act," Journal of Political Economy, University of Chicago Press, vol. 103(3), pages 551-572, June.
    14. Martin Pinquart & Silvia Sörensen, 2003. "Associations of Stressors and Uplifts of Caregiving With Caregiver Burden and Depressive Mood: A Meta-Analysis," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 58(2), pages 112-128.
    15. 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.
    16. 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).
    17. Lei, Xiaoyan & Sun, Xiaoting & Strauss, John & Zhang, Peng & Zhao, Yaohui, 2014. "Depressive symptoms and SES among the mid-aged and elderly in China: Evidence from the China Health and Retirement Longitudinal Study national baseline," Social Science & Medicine, Elsevier, vol. 120(C), pages 224-232.
    18. Hirst, Michael, 2005. "Carer distress: A prospective, population-based study," Social Science & Medicine, Elsevier, vol. 61(3), pages 697-708, August.
    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. Stefanie Behncke, 2012. "Does retirement trigger ill health?," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 282-300, March.
    21. Julie Robison & Richard Fortinsky & Alison Kleppinger & Noreen Shugrue & Martha Porter, 2009. "A Broader View of Family Caregiving: Effects of Caregiving and Caregiver Conditions on Depressive Symptoms, Health, Work, and Social Isolation," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 64(6), pages 788-798.
    22. Yumei Zhu & August Österle, 2019. "China's policy experimentation on long‐term care insurance: Implications for access," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1661-1674, October.
    23. Jonathan Gruber & James Poterba, 1994. "Tax Incentives and the Decision to Purchase Health Insurance: Evidence from the Self-Employed," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 109(3), pages 701-733.
    24. Sato, Mikiya & Hashimoto, Hideki & Tamiya, Nanako & Yano, Eiji, 2006. "The effect of a subsidy policy on the utilization of community care services under a public long-term care insurance program in rural Japan," Health Policy, Elsevier, vol. 77(1), pages 43-50, June.
    25. Li, Pei & Lu, Yi & Wang, Jin, 2016. "Does flattening government improve economic performance? Evidence from China," Journal of Development Economics, Elsevier, vol. 123(C), pages 18-37.
    26. Johan Ormel & Fruehling V. Rijsdijk & Mark Sullivan & Eric van Sonderen & Gertrudis I. J. M. Kempen, 2002. "Temporal and Reciprocal Relationship Between IADL/ADL Disability and Depressive Symptoms in Late Life," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 57(4), pages 338-347.
    27. Julien Forder, 2009. "Long‐term care and hospital utilisation by older people: an analysis of substitution rates," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1322-1338, November.
    28. He, Alex Jingwei & Qian, Jiwei & Chan, Wai-sum & Chou, Kee-lee, 2021. "Preferences for private long-term care insurance products in a super-ageing society: A discrete choice experiment in Hong Kong," Social Science & Medicine, Elsevier, vol. 270(C).
    29. 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.
    30. Martin Pinquart & Silvia Sörensen, 2006. "Gender Differences in Caregiver Stressors, Social Resources, and Health: An Updated Meta-Analysis," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 61(1), pages 33-45.
    Full references (including those not matched with items on IDEAS)

    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. 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).
    2. 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).
    3. Sun, Chuanwang & Zhan, Yanhong & Du, Gang, 2020. "Can value-added tax incentives of new energy industry increase firm's profitability? Evidence from financial data of China's listed companies," Energy Economics, Elsevier, vol. 86(C).
    4. 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).
    5. Michael Smart & Mark Stabile, 2005. "Tax credits, insurance, and the use of medical care," Canadian Journal of Economics, Canadian Economics Association, vol. 38(2), pages 345-365, May.
    6. Miao Guo & Yang Li & Minghao Wu & Terence C. Cheng, 2024. "Services and Cash: How Long-term Care Insurance Benefit Design Affects Household Behavior in China," Papers 2024-13, Centre for Health Economics, Monash University.
    7. Chang, Angela E., 1996. "Tax Policy, Lump-Sum Pension Distributions, and Household Saving," National Tax Journal, National Tax Association;National Tax Journal, vol. 49(2), pages 235-249, June.
    8. Parry, Ian W.H., 1999. "Tax Deductions, Consumption Distortions, and the Marginal Excess Burden of Taxation," Discussion Papers 10801, Resources for the Future.
    9. Triest, Robert K., 1998. "Econometric Issues in Estimating the Behavioral Response to Taxation: A Nontechnical Introduction," National Tax Journal, National Tax Association, vol. 51(n. 4), pages 761-72, December.
    10. Power, Laura & Rider, Mark, 2002. "The effect of tax-based savings incentives on the self-employed," Journal of Public Economics, Elsevier, vol. 85(1), pages 33-52, July.
    11. 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).
    12. Yang, Zhenbing & Fan, Meiting & Shao, Shuai & Yang, Lili, 2017. "Does carbon intensity constraint policy improve industrial green production performance in China? A quasi-DID analysis," Energy Economics, Elsevier, vol. 68(C), pages 271-282.
    13. Jiayi Wen & Xiaoqing Yu, 2024. "Insuring Long-Term Care in Developing Countries: The Interaction between Formal and Informal Insurance," Papers 2408.14243, arXiv.org.
    14. Triest, Robert K., 1998. "Econometric Issues in Estimating the Behavioral Response to Taxation: A Nontechnical Introduction," National Tax Journal, National Tax Association;National Tax Journal, vol. 51(4), pages 761-772, December.
    15. Chang, Angela E., 1996. "Tax Policy, Lump-Sum Pension Distributions, and Household Saving," National Tax Journal, National Tax Association, vol. 49(2), pages 235-49, June.
    16. 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).
    17. 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).
    18. 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.
    19. Mitra, Sophie & Gao, Qin & Chen, Wei & Zhang, Yalu, 2020. "Health, work, and income among middle-aged and older adults: A panel analysis for China," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    20. Xufei Zhang & Hongsheng Fang & Lin Guo, 2023. "Corporate Endowment Insurance Fee Reduction and Employee Wages: Evidence from China," China & World Economy, Institute of World Economics and Politics, Chinese Academy of Social Sciences, vol. 31(2), pages 192-222, March.

    More about this item

    Keywords

    LTC; Spillover effect; Functional limitation; Health; Well-being;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

    Statistics

    Access and download statistics

    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:340:y:2024:i:c:s0277953623008444. 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.