Wang Yuzi, Wang Weizheng, Zhang Yujie, Zeng Yuan
School of Social Sciences, Tsinghua University, Beijing, Beijing, China.
School of Philosophy and Social Development, Shandong University, Jinan, Shandong, China.
PLoS One. 2025 Apr 11;20(4):e0321057. doi: 10.1371/journal.pone.0321057. eCollection 2025.
China's Long-Term Care Insurance (LTCI) system is designed to address the caregiving needs of elderly individuals with disabilities and dementia, focusing on long-term care to ensure adequate survival and quality of life for disabled individuals. This study employs the PMC index model to evaluate LTCI policies in 16 pilot cities, including Changchun and Qingdao, using keyword extraction and social network analysis on the latest policy documents from these cities. The study revealed the following findings: (1) Among the 16 cities, only Qingdao's policy achieved a "perfect" rating, with two policies rated as "excellent," 11 as "acceptable," and two as "poor." (2) While most cities allow the involvement of commercial insurance in LTCI administration, there is a lack of clear policy direction for the assessment and service provision by commercial insurers. (3) Dementia care receives significantly less attention compared to physical disabilities. (4) Most cities have underdeveloped financing mechanisms, and family caregiving services are undervalued. Moreover, an analysis of representative policies based on the PMC surface indicates substantial differences between the pilot cities, with Qingdao's "perfect" policy serving as a model for future LTCI development. The study offers several recommendations: (1) Improve caregiver support policies to enhance family caregiving services. (2) Expand funding sources to increase the equity of LTCI financing. (3) Allocate insurance policy resources more effectively to gradually eliminate policy barriers. (4) Increase the focus on dementia care and clarify the criteria for assessing disability. (5) Strengthen the preventive function of LTCI and progressively expand its coverage. This research provides critical insights into the ongoing development of China's LTCI system and proposes viable strategies for promoting equity and sustainable growth.
中国长期护理保险（LTCI）制度旨在满足残疾及失智老年人的护理需求，专注于长期护理以确保残疾人士有足够的生存保障和生活质量。本研究采用PMC指数模型，通过对长春、青岛等16个试点城市的最新政策文件进行关键词提取和社会网络分析，来评估这些城市的长期护理保险政策。研究结果如下：（1）在16个城市中，只有青岛的政策获得了“完美”评级，两项政策评为“优秀”，11项评为“可接受”，两项评为“较差”。（2）虽然大多数城市允许商业保险参与长期护理保险管理，但商业保险公司在评估和服务提供方面缺乏明确的政策指导。（3）与身体残疾护理相比，失智护理受到的关注明显较少。（4）大多数城市的融资机制不发达，家庭护理服务被低估。此外，基于PMC曲面的代表性政策分析表明，试点城市之间存在很大差异，青岛的“完美”政策可作为未来长期护理保险发展的典范。该研究提出了几点建议：（1）完善护理人员支持政策，加强家庭护理服务。（2）扩大资金来源，提高长期护理保险融资的公平性。（3）更有效地分配保险政策资源，逐步消除政策障碍。（4）增加对失智护理的关注，明确残疾评估标准。（5）强化长期护理保险的预防功能，逐步扩大覆盖范围。本研究为中国长期护理保险制度的持续发展提供了关键见解，并提出了促进公平和可持续增长的可行策略。
