失能对老年人家庭的经济冲击及社会保险的调节作用

The Economic Impact of the Disabled-elderly on Their Households and the Adjustment Effect of Social Insurance Schemes

本文运用中国老人健康长寿影响因素跟踪调查(CLHLS)2011年、2014年两期的调查数据,构建Tobit固定效应模型和Mlogit固定效应模型分析老年人失能给家庭带来的经济冲击,以及现行的社会养老保险和社会医疗保险对这种冲击的调节作用。研究发现,老年人重度失能显著增加照料费用、住院费用,导致家庭医疗费用负担加重;老年人重度失能、中度失能均会显著增加照料时间。社会医疗保险和社会养老保险均对重度失能导致照料费用增加有一定的负向调节作用;社会医疗保险对中度失能带来的门诊费用增加有负向调节作用;社会养老保险对轻度失能、中度失能老人的门诊费用增加有正向调节作用。基于此,本文对长期护理保险制度、失能老人子女护理假制度、养老保险制度的改革提出几点建议。

This article constructs Tobit Fixed Effects Model and Mlogit Fixed Effects Model to analyze the economic impact of disabled-elderly on their households and the adjustment effect of current old age insurance and medical insurance based on the data of Chinese Longitudinal Healthy Longevity Survey(CLHLS)in 2011 and 2014.The study has found that the severe dysfunction of the elderly would significantly have their expenses increased in care and hospitalization,hence increasing the burden of medical expenditure by the family members;both severe and moderate dysfunction of elderly would significantly increase the time period required for caring the disabled-elderly.Both of social medical insurance and old age insurance have certain negative adjustment effect on the increase of the caring expense of the severe dysfunction;social medical insurance has certain negative adjustment effect on the increase in outpatient expense of the moderate disabled-elderly;old age insurance has positive effect on the increase in the inpatient expense on the minor and moderate disabled-elderly.Based on the findings,this paper puts forward recommendations on reform on the long-term care-giving insurance scheme,care leave scheme for the disabled-elderly’s children and the old age insurance scheme.