Study On The Impact Of Long-term Care Insurance On Medical Consumption Of Middle-aged And Elderly Rural Residents

Against the backdrop of increasingly severe aging and rapidly rising medical costs,excessive medical care has brought a heavy burden to families and society.How to maintain the health level of middle-aged and elderly residents while achieving medical cost control is a social problem that needs to be solved.From the practical experience at home and abroad,the long-term care insurance system provides useful reference for solving this problem.Based on the practice in our country,long-term care insurance can reduce the high medical expenses caused by long-term hospitalization,and on the other hand,it can solve the problems of family members not understanding medical care and inadequate home care,bringing more professional care services to middle-aged and elderly residents and improving their health status.This plays a crucial role in improving the health level of middle-aged and elderly residents,enhancing people’s well-being,and promoting social fairness and justice.Based on the health demand theory,Anderson’s medical service utilization model,public goods theory and moral hazard theory,this paper analyzes the impact of long-term care insurance on rural middle-aged and elderly residents’ medical consumption and its impact path by combing relevant domestic and foreign literature,using the China Health and Elderly Care Tracking Survey Database,using the double difference model and the mesomeric effect model.The main conclusions of the study are as follows:(1)The increasing aging rate and rapidly expanding medical expenses both bring heavy burdens to families and society.Long term care converts the medical needs of middle-aged and elderly people into care needs by establishing a prevention and rehabilitation nursing system,separates long-term care services from the medical service system,reduces unnecessary medical behavior,and effectively alleviates the problem of "social hospitalization",,thereby reducing medical costs without harming the health of middle-aged and elderly people,Achieve high-quality services and health protection at lower medical costs.(2)Based on a multi time point double difference model,analyze the impact of long-term care insurance on medical consumption of rural middle-aged and elderly residents.The research results indicate that long-term care insurance has a significant positive impact on the annual hospitalization expenses of middle-aged and elderly rural residents.Specifically,the implementation of long-term care insurance increased the annual hospitalization expenses of rural middle-aged and elderly residents by 2684.14 yuan,and the results passed the parallel trend test,robustness test and placebo test,and the benchmark regression results are credible.The above results indicate that the implementation of long-term care insurance can alleviate the problem of "social hospitalization",but the release effect on hospitalization demand is greater than the substitution effect,that is,the increase in annual hospitalization medical expenses is greater than the decrease.(3)Heterogeneity analysis was conducted from the perspectives of age and pilot areas.The research results showed that in terms of age heterogeneity,long-term care insurance had a significant positive impact on the annual hospitalization expenses of rural residents aged 61 to75,with an increase of 4745.45 yuan in annual hospitalization expenses.However,long-term care insurance did not have a significant impact on rural middle-aged and elderly residents aged 45 to 60 and 76 years and above.In terms of heterogeneity in pilot areas,the impact of long-term care insurance on medical consumption of rural middle-aged and elderly residents may have both short-term and long-term impacts.Specifically,the demand release effect generated by long-term care insurance in the short term is greater than the substitution effect,thereby increasing medical expenses,such as Shanghai,Jingmen,and Suzhou;But in the long run,after long-term care insurance releases medical needs,people’s health levels have improved,thereby reducing medical consumption expenses,producing cost control effects and value based medical services,such as Qingdao.(4)Based on the mesomeric effect model,this paper verifies the impact path of long-term care insurance on medical consumption of rural middle-aged and elderly residents.The research results indicate that both physical and mental health levels play an indirect role in the process of long-term care insurance affecting the medical consumption of rural middle-aged and elderly residents,and it is a masking effect.Specifically,the implementation of long-term care insurance has reduced the disability and depression of middle-aged and elderly rural residents,and improved their physical and mental health.However,due to moral hazard and excessive health demand after the event,the hospitalization medical expenses have increased.(5)Propose countermeasures and suggestions based on research conclusions.Firstly,optimize the long-term care insurance system and accelerate the pilot program in rural areas.Secondly,we need to reasonably control the increase in medical expenses through multiple channels.Thirdly,strengthen the management of physical and mental health of rural residents,and establish a correct view of medical consumption.