Research On The Driving Mechanism Of Chinese Residents' Willingness To Participate In Long-term Care Insurance

Most of existing literature on China's long-term care insurance(LTCI)is focusing on macro-level policy formulation and system design,whilst micro-level empirical investigations of residents' participation in LTCI are lacking.In fact,residents are subjects of LTCI and the sustainable development of LTCI relies mainly on residents' participation.Specifically,residents' willingness to participate in LTCI constitutes the direct driving force for LTCI construction.Without understanding residents' willingness to participate in LTCI,the system developed by the government may be disconnected from reality,and the insurance products designed by insurance companies cannot meet residents' diversified needs.Therefore,understanding residents' willingness to participate in LTCI is the key to ensure the effectiveness of LTCI system construction in China and to achieve precise marketing.Although several studies have explored the factors influencing the residents' willingness to participate in LTCI,most of these studies only list some of the most commonly debated factors,lacking systematic induction and corresponding mechanism analysis of the influencing factors.Based on this viewpoint,this dissertation will systematically explore the driving mechanism of residents' willingness to participate in LTCI,following the research route of “theory and literature foundation–qualitative research–quantitative research–policy recommendations”.By doing so,this dissertation will provide a solid basis for the implementation of LTCI and provide valuable references for the establishment of China's LTCI system.The major innovations of this dissertation and its research conclusions are as follows.(1)Qualitative research on the driving mechanism of Chinese residents' willingness to participate in LTCI.Based on grounded theory research methodology,I coded and analyzed the data collected from in-depth interviews.The analysis clarifies several main factors influencing residents' willingness to participate in LTCI and constructs a comprehensive theoretical model describing the driving mechanism of residents' willingness to participate in LTCI.This model is consisted of three main categories: resident attributes,psychological cognitions,and external contexts.On the basis of it,I propose an analytical framework consisting of three elements including cognition,situation,and intention,and further generate the following research hypotheses: the heterogeneity of resident attribute variables have important effects on residents' willingness to participate in LTCI;residents' psychological cognition variables can directly or indirectly affect their willingness to participate in LTCI;external context variables can moderate the relationship between residents' attitude and their willingness to participate in LTCI and thus can fill the gap between the two variables.(2)A quantitative study on the driving mechanism of Chinese residents' willingness to participate in LTCI.I conducted a statistical analysis of the survey data to examine the above-mentioned research hypotheses.The results indicate that: the heterogeneous residents have significant differences in their willingness to participate in LTCI;there is an obvious “attitude-behavioral intention” gap in the process of participating in LTCI,which is manifested as high-attitude and low-intention;residents' attitude toward participating in LTCI,perceived behavioral control,perceived usefulness,personal norm,trust level,and cultural values have significant and direct impacts on residents' willingness to participate in LTCI.Risk perception only has a significant and direct impact on residents' willingness to participate in LTCI.Perceived usefulness,personal norm,trust level,risk perception,and insurance knowledge indirectly affect the residents' participation willingness through the mediating role of attitude toward participating in LTCI;policy support as a context variable has a significant and positive moderating effect on the “attitude-intention” relationship and can fill the gap between them.In respect to policy implications,the dissertation suggests that Chinese government:introduce regulations on LTCI as soon as possible;promote the publicity of LTCI;change residents' conventional perception of long-term care;improve government supervision responsibilities;increase policy-level support and guidance;and increase the number of system pilots.In addition,this dissertation recommends insurance institutions: strengthen the promotion of commercial LTCI and knowledge related to LTCI;enhance residents' awareness toward long-term care risk and their awareness to participate in LTCI;and implement standardized internal management and design insurance products suitable for market needs.