长期护理保险与养老服务供给——基于新增市场主体视角的检验

Long-term Care Insurance and Elderly Care Service Supply:From the Perspective of New Market Entities

本文利用国家企业信用信息公示系统(NECIPS)2010—2020年发布的22469家养老护理服务机构数据,在双固定效应模型的框架下,采用交叠DID系统评估了中国长期护理保险制度试点对养老服务供给的影响。研究发现:长期护理保险显著扩大了养老服务供给,相比于非试点城市,增加了试点城市年度新增养老护理服务机构数量约13个,其中对机构所在地为城市地区以及对于“集中入住式”养老护理服务机构数量的促进作用更大;以“失能老人”和“养老服务”的百度指数作为中介变量进行机制分析发现,长期护理保险通过激发社会化养老护理服务需求,推动了养老服务供给的提升;通过企业生存分析方法,研究发现长期护理保险有效降低了养老护理服务机构的退出风险。本文研究为发挥长期护理保险制度优势,挖掘养老护理服务资源,推动养老产业发展,实现“老有所护“”老有所养”提供决策参考。

As China undergoes continuous aging,the expansion of elderly care services has become imperative for the development of the elderly care industry,addressing the urgent needs and concerns of the general public,and aligning with the goals of providing“care and support for the elderly”and ensuring their well-being.Long-term care insurance(LTCI)policy plays a significant role in providing home-based or institutional elderly care services for disabled people.It not only meets the realistic and potential demands of the public for socialized elderly care services to a certain extent,but also contributes to strengthening the admission,management,and service quality assessment of designated care institutions.This study uses data from 22,469 elderly care service institutions released by the National Enterprise Credit Information Publicity System(NECIPS)between 2010 and 2020.It uses“the annual growth of elderly care service institutions”to measure the supply of elderly care services.Employing staggered difference-in-differences(DID)approach within the framework of two-way fixed effects model,this study empirically examines the impact of China's long-term care insurance pilot program on the supply of elderly care services.The results indicate that LTCI significantly expands the supply of elderly care services.Compared with the non-pilot cities,the annual growth of elderly care service institutions in pilot cities has increased by approximately 13.This positive impact becomes evident in the second year after the pilot initiation,gradually expanding over time and showing a degree of sustainability.Heterogeneity analysis reveals that LTCI has a more pronounced effect on urban areas and centralized residential care institutions.A mechanism analysis,using the Baidu index for“disabled elderly”and“elderly care services”as mediating variables,indicates that LTCI stimulates the demand for socialized elderly care,consequently leading to an increase in the supply of elderly care services.Moreover,this study finds that LTCI reduces the risk of existing elderly care service institutions exiting the market,thereby contributing to the continuity and development of such institutions.This study provides several policy implications.Firstly,it recommends continued utilization of the driving force provided by LTCI in the elderly care service industry,ensuring full realization of the principle of“care and support for the elderly”.Secondly,we should guide elderly care service resources toward expanding into rural areas,promoting the construction and development of elderly care service institutions in these regions.Thirdly,we should also consider the development of both new and existing institutions,extending the lifecycle of current institutions to ensure their longevity,and contributing to the healthy,stable,and sustainable development of the industry.This study contributes to existing literature in the following aspects.Firstly,it focuses on the impact of LTCI on the supply of elderly care services from the perspective of the annual growth of elderly care service institutions.This extends research on the implementation effects of LTCI.Secondly,with public attention as a channel,this study examines how LTCI affects the supply of elderly care services through the demand for socialized elderly care services,providing new insights for advancing the construction and development of elderly care service institutions.Thirdly,this study extends research to the role of LTCI in ensuring the continuity of elderly care service institutions.This empirical examination offers valuable evidence regarding both opportunities and challenges in the development of the elderly care service industry.