Impact of long-term care insurance on medical expenditure and utilization and the comparison between different pilot schemes: evidence from China

Yifan Yao ; Shanshan Yin ; Wen Chen ; Changli Jia ; Qiang Yao ; Shanquan Chen ORCID logo ; Junnan Jiang ; Kunhe Lin ; Zhengdong Zhong ; Yingbei Xiong ; +1 more... Li Xiang ; (2025) Impact of long-term care insurance on medical expenditure and utilization and the comparison between different pilot schemes: evidence from China. BMC public health, 25 (1). p. 1379. ISSN 1471-2458 DOI: 10.1186/s12889-025-22610-w
Copy

Objectives:

This study investigates the effect of long-term care insurance (LTCI) on medical expenditure and utilization in China and compares the effects between different pilot schemes.

Methods:

We used four-wave data from the China Health and Retirement Longitudinal Study (CHARLS) 2011-2018, covering 19 cities piloted by national government or local governments. We applied a staggered difference-in-differences (DID) strategy to identify the effect of LTCI. Heterogeneity tests were used to identify the effects of different pilot schemes.

Results:

We found that LTCI implementation significantly reduces inpatient expenditure, annual inpatient visits, and monthly outpatient visits by 13.4%, 0.033, and 0.072, respectively. The effects of LTCI become more pronounced in pilot cities with government subsidies in financing or higher reimbursement ceilings. Compared to pilot schemes covering UEBMI & URRBMI program, the schemes only covering UEBMI program could significantly reduce inpatient and outpatient frequency by 0.029 and 0.069. Pilot schemes with more service items had lower outpatient frequency (β = -0.146), and pilot schemes with fewer service items had lower inpatient expenditure and frequency (β = -0.226 and β = -0.049).

Conclusion:

In general, this study found that LTCI implementation could effectively reduce the expenditure and utilization of medical services. The effects of different pilot schemes vary significantly. The results of this study further supplement the existing empirical evidence on the effect of LTCI and provide important policy implications for the future development of LTCI in China and other developing countries.


picture_as_pdf
Yao-etal-2025-impact-of-long-term-care-insurance-on-medical-expenditure-and-utilization-and-the-comparison-between-different-pilot-schemes.pdf
subject
Published Version
Available under Creative Commons: Attribution-NonCommercial-No Derivative Works 4.0

View Download

Atom BibTeX OpenURL ContextObject in Span Multiline CSV OpenURL ContextObject Dublin Core Dublin Core MPEG-21 DIDL Data Cite XML EndNote HTML Citation JSON MARC (ASCII) MARC (ISO 2709) METS MODS RDF+N3 RDF+N-Triples RDF+XML RIOXX2 XML Reference Manager Refer Simple Metadata ASCII Citation EP3 XML
Export

Downloads