长期护理保险对自付医疗费用的影响

The effect of long⁃term care insurance on out⁃of⁃pocket medical expenses

面对人口迈向中度老龄化与医疗费用攀升的现实难题,长期护理保险为破除这一困境提供契机。文章基于中国健康与养老追踪调查(CHARLS)2011、2013、2015和2018年四期数据,运用双重差分法分析第一批长期护理保险试点政策对试点城市目标群体的自付医疗费用支出的影响。结果显示,长期护理保险显著降低中老年群体的自付医疗费用。上述实证结果通过了一系列稳健性检验。进一步的,长期护理保险对自付医疗费用的降低作用在城镇和西部地区更为显著。该实证研究结果对长期护理保险试点范围的推广和待遇设计的完善具有现实意义。

Long⁃term care insurance provides an opportunity to break the dilemma under the practical problem of the moderately aging population and rising medical costs in China.Based on data from China Health and Retirement Longitudinal Study(CHARLS)in 2011,2013,2015 and 2018,this paper analyzes the impact of the first batch of long⁃term care insurance pilot policies on the out⁃of⁃pocket medical expenses of target groups in pilot cities using the Difference⁃in⁃Difference method.The results showed that long⁃term care insurance significantly reduced out⁃of⁃pocket medical expenses for the middle⁃aged and elderly population.The above empirical results have passed a series of robustness tests.Furthermore,the effect of long⁃term care insurance on reducing out⁃of⁃pocket medical costs is more significant in urban and western areas.The empirical results of this paper have practical implications for extending the pilot range of long⁃term care insurance and refining the treatment design.