供需平衡视角下长期护理保险的实施效果  

Effectiveness of Long-term Care Insurance from the Perspective of Supply and Demand Balance

作　　者：周博 赵绍阳[2] ZHOU Bo;ZHAO Shaoyang(Southwestern University of Finance and Economics,Chengdu,China;Sichuan University,Chengdu,China)

机构地区：[1]西南财经大学经济学院,611130 [2]四川大学经济学院,610065

出　　处：《经济学动态》2024年第5期109-126,共18页Economic Perspectives

基　　金：国家自然科学基金面上项目“临终前医疗支出水平及其经济效率的实证评价”(72273094);四川省科技厅软科学项目“成都市长期照护险实施效果的评价”(2022JDR0181)。

摘　　要：通过社会保险来应对失能风险是我国实施健康老龄化战略的重要举措之一。本文利用多源数据刻画了中国长期护理市场的特征事实,并从需求侧和供给侧分别检验了长期护理保险的实施效果。通过研究发现,需求侧方面的非正式照料是失能人员的主要选择,但随着少子化趋势的加剧,该模式将不可持续;供给侧方面则呈现养老机构床位过剩与专业养老护理员不足的特点,而新增床位的补贴政策和养老护理员的“工资惩罚”是其重要原因。长期护理保险在总体上增加了家庭的非正式照料,但保险给付模式的差异影响了失能人员对正式照料和非正式照料的选择。长期护理保险的实施对供给侧养老机构数量、从业人员、机构床位数以及入住价格在短期内均没有显著影响。本文的研究结果为促进长期护理市场发展和优化长期护理保险制度设计提供了经验证据。The rapid aging of China's population structure has garnered significant attention.As the population ages,the number of the disabled elderly population in China is expected to rise considerably.However,China's social security system is not yet comprehensive,with limited government subsidies and service support for disabled elderly population.Therefore,how the government can formulate corresponding policies to address the risk of disability is a worthwhile research question.This paper analyzes the stylized facts of China's long-term care market and investigates the effects of long-term care insurance using rich data.Initially,this paper presents four observations about the long-term care market from both demand and supply perspectives.Firstly,informal care is the primary option for people with disabilities.Secondly,as the trend of low birthrate intensifies,informal care becomes unsustainable.Thirdly,there is an oversupply of beds in nursing homes,largely due to government subsidy policies.Fourthly,the supply of professional elderly care workers is inadequate due to wage penalties in the labor market.Next,this paper develops a theoretical model to analyze the mechanisms of long-term care insurance policies.China initiated long-term care insurance pilots in 2016,providing policy interventions for disabled individuals through cash subsidies and service support.Based on this,this paper constructs a theoretical model to illustrate how long-term care insurance affects the demand for long-term care services among disabled individuals,decomposing this into substitution,income,and health effects.Additionally,this paper employs a general equilibrium model to assess the impact of changes in demand induced by long-term care insurance on the supply of long-term care.Finally,this paper uses a difference-in-differences(DID) model to evaluate the impact of long-term care insurance policies.Regression results reveal that long-term care insurance significantly increases informal care at home on the demand side.Furthermore,payment m

关 键 词：长期护理保险 需求侧效应 供给侧效应 

分 类 号：F842.6[经济管理—保险]