Research On The Effect Of Long-Term-Care Insurance Policies On Individual Medical Expenses

China has entered an aging society and the cost of medical care continues to rise,but the social pension system,the system of nursing care institutions and the level of medical personnel do not match it seriously.In order to deal with how to maintain the health level of middle-aged and elderly people while controlling medical expenses,China has explored the long-term care insurance system.After six years of development,the policy has been effective,and the scope of protection has been gradually expanded from urban to rural areas.The funding channels,benefits and criteria for determining disability are being developed and improved in a people-oriented,scientific and humane manner.However,due to problems such as overlapping responsibilities of nursing care facilities and medical institutions,which lead to increased utilization of medical services for the elderly thus leading to higher medical costs,long-term care has to go back to its roots to consider the scope of its functional positioning authority and responsibility as well as the effect on medical costs.This study uses four periods of panel data from CHARLS 2011-2018 to examine the effect of long-term care insurance on health care expenditures.Firstly,relevant concepts such as the meaning and characteristics of long-term care and long-term care insurance are defined,followed by sorting out the current policy status of long-term care insurance in China.On this basis,a double difference propensity score matching method(PSM-DID)model was used to analyze the effect of long-term care insurance policy after its implementation by comparing the difference in medical expenses incurred by the treatment and control groups before and after the implementation of long-term care insurance policy.This thesis confirms that the implementation of long-term care insurance policy had a substitution effect on the utilization of medical services in terms of hospitalization,significantly reducing hospitalization costs: the average number of hospitalizations in the previous year decreased by 0.14,the average out-of-pocket hospitalization costs in the previous year decreased by $596.9,and the total hospitalization costs in the previous year decreased by $1,800;among the group with improved health status of the elderly in terms of hospitalization,as a result of the long-term care insurance system The implementation of the long-term care insurance system also significantly reduced inpatient medical costs,confirming the health effect of long-term care insurance;while the utilization and costs of outpatient-related medical services in the previous month were increasing due to the high fluctuation in the probability of short-term elderly morbidity and the decrease in the number of outpatient visits,and all of them were not significant,i.e.,the long-term care insurance system was implemented to release the care needs of the elderly and the increase in the utilization and costs of outpatient medical services.To verify that the results are robust,robustness tests were conducted using the reduced tail treatment,placebo test,and Abadie SDID reweighted regression,respectively.In response to the results of the empirical study this thesis concludes that the overall health care resource utilization and costs of the elderly group are increasing year by year;the implementation of long-term care insurance is found to have a positive effect on relieving the pressure on health care resources and reducing health care expenditures.It then discusses why there is no significant change in outpatient costs after the implementation of long-term care insurance policy;whether long-term care insurance policy has a substitution effect on inpatient costs,but whether it has an impact on the quality of medical services for the elderly;what the impact of long-term care insurance policy is on medical expenditures for the elderly in the long term;and an exploration of the long-term care insurance system.Finally,suggestions are given to improve the quality of medical services and encourage family doctor contracting;further improve the design of long-term care insurance system to play the role of social security;and strengthen health management and disease prevention measures for the elderly to realize value-based medical policies.