长期护理保险对中老年人门诊利用和医疗费用的影响

Effect of long-term care insurance on outpatient utilization and medical expenses in middle-aged and elderly people

随着人口老龄化的不断加剧,失能人群的增加,医疗费用无序扩张等问题危及医疗保障体系的可持续发展。文章基于中国健康养老与追踪调查2011年、2013年、2015年和2018年四期数据,采用双重差分法探究长期护理保险对门诊利用和医疗费用的影响。结果表明,长期护理保险可以显著减少自付医疗费用和门诊次数。异质性分析发现,相比城市职工医疗保险人群,长期护理保险对城乡居民医疗保险参保人群影响更大;长期护理保险降低了中高收入家庭医疗费用,而对低收入家庭影响甚微。这些结论验证了长期护理保险的实施价值,并为新一轮医疗改革和试点范围的扩大提供了有益参考。

A growing aging population, disabled population, and the disorder expansion of medical expenses threaten the sustainable development of the healthcare security system. Based on the data from China Health and Retirement Longitudinal Study in 2011,2013,2015,and 2018,this study used the Differences-inDifferences to explore the effect of long-term healthcare insurance on outpatient utilization and medical expenses. The results show that long-term healthcare insurance can significantly reduce out-of-pocket medical expenses and outpatient visits. The heterogeneity analysis showed that long-term healthcare insurance had a more significant impact on urban and rural healthcare insurance participants than that of the urban workers. At the income level,long-term healthcare insurance reduced medical costs for middle and upper-income families but had little effect on low-income families. These conclusions validated the value of long-term healthcare insurance and provided a meaningful reference for the new round of medical reform and the expansion of pilot scope in China.