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中国长期护理保险对配偶健康与福祉的“溢出效应”。

The "spillover effect" of long-term care insurance in China on spouses' health and well-being.

作者信息

Luo Yanan, Yuan Kexin, Li Yuxiao, Liu Yating, Pan Yao

机构信息

Department of Global Health, School of Public Health, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China.

School of Software and Microelectronics, Peking University, Beijing, China.

出版信息

Soc Sci Med. 2024 Jan;340:116487. doi: 10.1016/j.socscimed.2023.116487. Epub 2023 Dec 7.

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.

摘要

本研究考察了长期护理保险(LTCI)对有长期护理需求预期或实际护理负担的中国中老年成年人配偶的健康状况和幸福感的溢出效应。利用2011年至2018年中国健康与养老追踪调查的面板数据,我们采用双重差分(DID)方法研究了多个城市引入长期护理保险试点对老年人的影响。我们发现,长期护理保险对有功能障碍的中老年配偶的健康和幸福状况产生了溢出效应。这可能是因为长期护理保险可以通过减少自付医疗费用来减轻经济负担,进而影响配偶的健康和幸福感。研究发现,对男性配偶和低学历配偶而言,长期护理保险对健康和幸福感的溢出效应更强。80岁以下且没有成年子女同住的老年人的配偶更有可能从长期护理保险的引入中受益。此外,提供组合福利似乎比提供直接服务更能让配偶受益。因此,研究结果表明,扩大长期护理保险不仅有助于受护理者本人,还能改善功能受损老年人配偶的健康和幸福感。

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