医疗和养老保险与高龄失能老人长期照料支出——基于CLHLS数据的实证分析

Impact of medical and pension insurance on the long-term care expenses for the Chinese disabled elderly: An empirical analysis based on CLHLS data

我国尚未建立全国性的长期护理保险制度,老年人的长期照料费用主要由家庭承担,老年人拥有的医疗和养老保障是否影响其长期照料服务利用尚不清楚。利用2011年中国老年健康长寿调查(CLHLS)数据,构建两部模型,分析医疗与养老保险对我国城乡高龄失能老人长期照料支出的影响。研究结果表明,我国城镇高龄老人的长期照料支出显著高于农村高龄老人。公费医疗保险、新农合和养老保险对高龄老人长期照料支出有显著影响,且存在城乡差异。城镇高龄老人享有的医疗和养老保险既影响长期照料支出发生与否,又影响长期照料支出的多寡;农村高龄老人享有的医疗和养老保险仅对其是否发生长期照料支出有影响,对支出数量的影响不显著。建议通过加大医疗和养老保障强度,建立长期护理保险制度,减轻高龄老人家庭长期照料经济负担。

China has not established the national long-term care insurance system,the long-term care expenses being mainly borne by the family,which leads to an unclear long-term care service utilization. This paper analyzes the impact of medical and pension insurance on the long-term care expenses for the Chinese disabled elderly by constructing a two-part model based on the data of Chinese elderly longitudinal healthy longevity survey conducted in2011. The results showed that the long-term care expenditure of the urban elders with disabilities is significantly higher than that of the rural ones. Although free public health insurance,the New Rural Cooperative medical insurance and endowment insurance have certain impact on the elderly long-term care expenditure,their effectiveness is different between the rural and urban areas. The urban elders＇ medical and pension insurance exerts influence on both the existence and the amount of the long-term care expenses. However,the rural elders＇ medical and pension insurance only have impact on the existence of the long-term care expenses,but the effect is not significant. It is suggested that China has to strengthen medical and pension insurance and build long-term care insurance system to lighten the financial burden of the families of elders with disabilities.