长期照护保险对老年人医疗花费的替代效应

The Substitution Effect of Long-Term Care Insurance on Medical Expenditure of the Elderly

目的:基于成都市长期照护保险试点政策,研究长期照护保险对老年人医疗花费的替代效应。方法:利用2014—2020年成都市某老年人医院病案首页数据,构建双重差分模型。结果:长期照护保险的实施显著降低了城镇职工基本医疗保险重度失能住院患者的医疗总费用、服务费用和药品费用,住院天数显著下降,而住院检查费用没有显著变化。结论:长期照护保险的实施医院护理服务形成了有效替代,从而减轻了老人费用负担以及医保基金支付压力。

Objective:Based on the long-term care insurance pilot policy in Chengdu,the substitution effect of long-term care insurance on medical expenditure of the elderly was studied.Methods:Using the data of the home page of an elderly hospital case in Chengdu from 2014 to 2020,a difference-in-differences model was constructed.Results:The results showed that the implementation of long-care insurance significantly reduced the total medical expenditure,service expenditure,and medicine expenditure of urban employee basic medical insurance patients with severe disability.The number of hospitalization days was significantly lower,while there was no significant change in diagnostic test expenditure.Conclusion:The implementation of long-term care insurance created an effective alternative to hospital care services,thereby reducing the burden for the disabled and the pressure on health insurance fund payments.