Research Of Long-term Care Insurance’s Impacts On Health Status Of Disabled Elderly

At present,our country is facing the severe problem of population aging,which poses a serious challenge to social security and economic development.With the problem of population aging accompanied by declining birth rates and rising disability rates,the birth rate fell below 1 percent for the first time in 2021,the population structure has far exceeded the international standard of an aging society and entered the society of "getting old before getting rich." Under the trend of population aging,how to care for the elderly while achieving social stability and sustaining economic growth has become an important challenge to the government and society.In order to improve the health problems of disabled elderly,establish a harmonious and beautiful environment for the elderly,our country started to pilot long-term care insurance in 2012.Up to now,49 cities have carried out pilot programs to actively explore reasonable and effective long-term care insurance policies.Compared with foreign countries,long-term care insurance appears so late in our country and is still in the pilot stage,which is not perfect in many aspects of construction.Since the pilot of long-term care insurance,a large number of domestic scholars have carried out in-depth research and discussion on long-term care insurance to promote the improvement of long-term care policy.Most scholars paid attention to pricing,financing,and demand analysis of long-term care insurance,and some scholars paid attention to the impact of long-term care insurance on medical expenses.Nevertheless,the fundamental purpose of long-term care insurance is to improve the status of health of the elderly,but few scholars paid attention to the health status of the disabled elderly.Therefore,based on previous studies,this paper further studies the impact of long-term care insurance on the health status of disabled elderly in China.This paper studies the impact of long-term care insurance on the health status of disabled elderly in China from five chapters.Chapter one is the introduction.The introduction mainly includes the research background,research significance,literature review,research methods,research content and structure,and innovation points.Chapter two is the theoretical basis and concept definition.This part includes the elaboration of welfare pluralism theory,Grossman’s theory of health needs,the definition of disabled elderly and long-term care.The third chapter is empirical analysis.This part includes data sources,long-term care insurance beneficiary determination,model construction process,variable selection,main research hypothesis,descriptive statistics,empirical analysis.The fourth chapter is heterogeneity analysis and robustness test.In this part,heterogeneity analysis was carried out on the elderly with different genders,different levels of education,and abled elderly,robustness test was conducted by selecting sub-samples and replacing explained variables.The fifth chapter is the summary and prospect.This part includes the main research conclusions,suggestions for long-term care policy,shortcomings,and suggestions for improvement.Panel data of 2014 and 2018 from the Chinese Longitudinal Healthy Longevity Survey are selected as research data in this paper.Based on the long-term policies of Shanghai,the moderately and severely disabled elderly in Shanghai are selected as beneficiaries of long-term care insurance(experimental group).Since some provinces and cities have not implemented the pilot program of long-term care insurance in 2018 or before,the moderately and severely disabled elderly in Beijing,Tianjin and Fujian are selected as the control group based on per capita GDP ranking and per capita health expenditure among provinces or cities that have not implemented the pilot program of long-term care insurance.The difference-in-difference model is established with self-rated health,MMSE,resting heart rate,and BMI as the explained variables.Then based on the empirical results,heterogeneity analysis and robustness test are completed.The empirical results show that long-term care insurance can effectively improve the health status of the disabled elderly,but there is heterogeneity among the disabled elderly with different degrees of disability,different genders,and different education.Firstly,long-term care insurance can effectively improve the self-rated health of the severely disabled elderly,especially for male or lower education level disabled elderly.Secondly,long-term care insurance can effectively improve the MMSE of the disabled elderly,especially for male or lower education level disabled elderly.Thirdly,long-term care insurance can effectively improve the resting heart rate health of disabled elderly,especially for male or higher education level disabled elderly.But long-term care insurance had no significant effect on the BMI of disabled elderly.At last,based on the results of this empirical analysis,some long-term policy suggestions are put forward:promote the long-term care payment for the moderately disabled elderly,improve the health status of them;promote security for urban and rural residents,expand the coverage of the long-term care system;formulate individualized plans for disabled elderly,and improve grading nursing system in the long-term care insurance;strengthen health education for disabled elderly,and guide them to establish a positive view of health;develop the market of elderly care,promote the construction of nursing institutions and personnel.At the same time,based on the study of foreign advanced experience,this paper proposed to build a diversified care system.