我国长期护理保险对中老年人医疗费用支出的影响研究--基于中国健康与养老追踪调查数据

The Impact of Long-term Care Insurance on Medical Expenditure for Middle-aged and Elderly People in China--Empirical Analysis Based on CHARLS

随着我国中老年人口失能率不断升高,长期护理保险在社会保障制度架构中的重要性日益突出,是积极应对老龄化挑战的关键措施。文章选用2015年和2018年中国健康与养老追踪调查(CHARLS)的两期面板数据,采用倾向得分基础上的倍差法(PSM-DID)研究长期护理保险对中老年人医疗费用支出的影响。研究发现:长期护理保险对门诊费用支出有显著负向影响,而对住院费用支出的影响不显著,该结论在一系列稳健性检验后仍可成立。异质性分析表明,长期护理保险对低教育程度、东部地区和老年人群的门诊控费效果更好。未来长期护理保险的发展应全方位实现控费目标,减轻护理者和受护者负担,同时发挥健康效应。

With the increasing incapacity rate of the middle-aged and elderly population in China,long-term care insurance(LT⁃CI)plays an significant role in the social security system structure,which is a key measure to actively cope with the challenges of aging.Panel data of China Health and Retirement Longitudinal Study(CHARLS)in 2015 and 2018 were selected to study the im⁃pact of LTCI on medical expenditure for middle-aged and elderly people by using PSM-DID.The empirical results indicate that LTCI had a significant negative effect on outpatient expenditure,but has no significant effect on inpatient expenditure,and this con⁃clusion remained true after a series of robustness tests.Heterogeneity analysis shows that LTCI can better control the outpatient ex⁃penditure among low education level,eastern region and elderly population.In the future,the development of LTCI should achieve the goal of controlling expenditure in all aspects,reduce the burden of nurses and patients and play the health effect.