Wilson C E, Weissert W G
School of Public Health, University of North Carolina, Chapel Hill.
Inquiry. 1989 Winter;26(4):493-507.
Private long-term care insurance has been suggested as a solution to the crushing burden of out-of-pocket expenditures for nursing home and home health care. This paper examines the effects of common policy restrictions among currently marketed policies, more than a million of which have been sold. Using a conditional probabilities model and data from the 1985 National Nursing Home Survey (NNHS), we estimate likelihood of policy compliance for 31 combinations of policy restrictions. Compliance estimates range from 8.5% to 91.9%. Results indicate that prior hospitalization and prior skilled care clauses represent significant stumbling blocks for policyholders seeking benefit payments.
私人长期护理保险被认为是解决疗养院和家庭医疗自付费用沉重负担的一种办法。本文研究了目前市场上销售的保险单中常见政策限制的影响，这些保险单已售出超过一百万份。我们使用条件概率模型和1985年全国疗养院调查（NNHS）的数据，估计了31种政策限制组合的保单合规可能性。合规估计范围从8.5%到91.9%。结果表明，先前住院条款和先前专业护理条款对寻求保险金赔付的投保人来说是重大障碍。
