Accessing long-term care social insurance benefits in South Korea and its correlates

Little is known about the factors important in explaining the demand for long-term care (LTC) insurance benefits in the context of universal public coverage. In this paper, we utilize data from the 2014-2018 Korean Longitudinal Study of Aging to examine who applies for LTC service benefits in South Korea’s LTC social insurance system. Subjects are community-dwelling adults aged 60 and above. Our research design considers multiple dimensions of health, including physical health, cognitive health, as well as mental health. We also examine whether people’s expectations of receiving care in the future differ depending on their mental well-being. We find that all three dimensions of health are germane to formal LTC demand: specifically, the presence of functional limitations, depressive symptoms, and moderate-severe cognitive impairment are all independently and positively associated with the outcome. Also, those who apply for benefits tend to have greater trust in the scheme administrator and expect care from hired help. Older Koreans who anticipate receiving informal care from a family member are less likely to apply for formal LTC. Notably, this negative association is driven by people’s expectation of spousal care rather than expectation of care from a child or grandchild. We find suggestive evidence that the effects of spousal care expectation on accessing formal LTC services are most pertinent for older persons who are depressed. Policymakers should take into account the various dimensions of older adults’ health status and recognize their heterogeneity in care expectations in estimating future demand for benefit claims in public LTC schemes.