长期护理保险对老年家庭照料的影响

The Effect of the Long-Term Care Insurance on Family Care for the Elderly

如何缓解家庭照料压力、弥补老年照护人力资源短缺是中国积极应对人口老龄化国家战略面临的重大现实问题。文章使用中国健康与养老追踪调查(CHARLS)2011、2013、2015、2018年数据,并与相应年份地区统计年鉴数据匹配形成四期面板数据,采用渐进双重差分方法考察长期护理保险对家庭照料的影响。研究结果表明:(1)长期护理保险显著挤出了家庭提供的老年照料时间,使试点地区失能老人家庭提供的日均照料时间下降44.8%,显著缓解了家庭照料服务的压力。(2)从动态效应看,长护险的政策效应表现出一定程度的滞后性,且随时间变化呈增强趋势。(3)长护险对缓解重度失能老人的家庭照料压力更为显著,城镇地区的政策效应强于农村地区。(4)长护险对家庭照料时间的挤出并没有伴随着家庭转移支付的显著下降,但减少了子女提供的陪伴和情感联络。(5)长护险对家庭照料时间的挤出并没有以损害中老年人的健康为代价,且降低了其医疗服务的利用,一定程度上改善了中老年人的健康。文章认为,长期护理保险制度在缓解家庭照料压力的基础上,应重视对家庭照料功能的支持,促进子女对老年父母的陪伴和情感联络。随着长护险制度不断扩面,着重推动农村地区失能老人对专业化护理服务的利用有利于缓解农村家庭照料压力。

How to relieve the pressure of family care and solve the manpower shortage of elderly care?This has been a big challenge in China's national strategy to actively cope with population aging.Using the panel data of China Health and Retirement Longitudinal Study(CHARLS)from 2011 to 2018 and the regional data from statistical yearbooks,this study examines the impact of the long-term care insurance on family care for the elderly with the time-varying difference-in-differences method.The results show that,firstly,the long-term care insurance reduces the average daily family caring time for the disabled elderly by 44.8%in pilot areas,which significantly relieves the pressure of family care for the elderly.Secondly,the effect of the long-term care insurance has a time lag,and it reinforces over time.Thirdly,the long-term care insurance plays a more significant role in relieving the pressure of family care for the severely disabled elderly,and the effect is stronger in urban areas than their rural counterparts.Fourthly,the long-term care insurance does not reduce family transfer payments,although it reduces the companionship and emotional contacts provided by children.Finally,the crowding-out effect of the long-term care insurance on family care time does not harm the health of the middle-aged and elderly people.To the contrary,it reduces the use of medical care services,and improves the health of the middle-aged and elderly people.The conclusive remark is made on the importance of paying attention to family care functions and the accompanying and emotional contacts between children and their elderly parents.And it is also important to promote the rural disabled elderly in using professional care services so as to relieve their family pressure in care providing.