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在超老龄化社会中对私人长期护理保险产品的偏好:来自香港的离散选择实验。

Preferences for private long-term care insurance products in a super-ageing society: A discrete choice experiment in Hong Kong.

机构信息

Department of Asian and Policy Studies, The Education University of Hong Kong, Hong Kong, China.

East Asian Institute, National University of Singapore, Republic of Singapore.

出版信息

Soc Sci Med. 2021 Feb;270:113632. doi: 10.1016/j.socscimed.2020.113632. Epub 2020 Dec 20.

Abstract

There is a stark contrast between rising long-term care (LTC) demands and limited financing capacity in many ageing societies. Despite the theoretical potential of private insurance in LTC financing reforms, the reality is that the market remains remarkably underdeveloped. This study adopts a novel two-phase approach to quantitatively examine the market demand for private long-term care insurance (LTCI) in Hong Kong, one of the world's super-ageing societies. In order to examine people's preferences regarding private LTCI in Hong Kong, which has been exploring alternative LTC financing mechanisms to relieve the overburdened public system, we conducted a discrete choice experiment (DCE) in 2019 to elicit the preferences of a representative sample of 410 middle-aged adults. At first, we used data from the US National Longterm Care Survey to perform an actuarial projection for Hong Kong. In the first phase, we computed the indicative premiums based on various attributes of hypothetical private LTCI products. Undertaken in the second phase and using two econometric techniques, the DCE suggested that the most preferred hypothetical LTCI product in Hong Kong was associated with the following features: 1) a monthly benefit level of HK$20,000 or HK$25,000, 2) 3% inflation protection, and 3) 15 years of contribution. These attributes led to a monthly premium of HK$1237 (US$160)/HK$1546 (US$200) for men and HK$2150 (US$278)/HK$2687 (US$348) for women. Furthermore, we also found that the preference for LTCI products varied across people with different socioeconomic and health characteristics. These insights could inform initial market segmentation, LTCI product design, and targeted marketing in the future. This paper concludes with cautious optimism regarding the market demand for private LTCI in Hong Kong, and recommends concrete policy instruments to nurture the LTCI market, including information campaign, premium subsidies, and tax benefits.

摘要

在许多老龄化社会中,长期护理(LTC)需求不断上升与融资能力有限形成鲜明对比。尽管私人保险在 LTC 融资改革中具有理论潜力,但实际上,市场的发展仍然非常有限。本研究采用新颖的两阶段方法,定量研究了香港这个世界超级老龄化社会之一对私人长期护理保险(LTCI)的市场需求。为了研究香港人对私人 LTCI 的偏好,香港一直在探索替代长期护理融资机制,以缓解负担过重的公共系统,我们于 2019 年进行了一项离散选择实验(DCE),以了解具有代表性的 410 名中年成年人的偏好。首先,我们使用来自美国国家长期护理调查的数据对香港进行精算预测。在第一阶段,我们根据假设的私人 LTCI 产品的各种属性计算了指示性保费。在第二阶段,我们使用了两种计量经济学技术,DCE 表明,香港最受欢迎的假设 LTCI 产品具有以下特征:1)每月保障水平为 20,000 港元或 25,000 港元,2)3%的通胀保护,以及 3)15 年的缴费期。这些属性导致男性每月保费为 1237 港元(160 美元)/1546 港元(200 美元),女性每月保费为 2150 港元(278 美元)/2687 港元(348 美元)。此外,我们还发现,LTCI 产品的偏好因具有不同社会经济和健康特征的人而异。这些见解可以为未来的初始市场细分、LTCI 产品设计和有针对性的营销提供信息。本文对香港私人 LTCI 的市场需求持谨慎乐观的态度,并建议采用具体的政策工具来培育 LTCI 市场,包括信息宣传、保费补贴和税收优惠。

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