长期护理保险如何影响老年人心理健康?  

How Does Long-Term Care Insurance Affect Mental Health of the Elderly?

作　　者：刘晓昀[1] 姬琳雪 Liu Xiaoyun;Ji Linxue(College of Humanities and Development Studies,China Agricultural University)

机构地区：[1]中国农业大学人文与发展学院

出　　处：《劳动经济研究》2024年第3期35-63,共29页Studies in Labor Economics

摘　　要：老年人是中国自杀率最高的群体,如何解决老年群体日益凸显的心理健康问题已成为一大社会性难题。本文采用中国健康与养老追踪调查(CHARLS)2011-2020年五期数据,运用渐进双重差分模型,实证探究了长期护理保险对老年人心理健康的影响效应和作用机制。研究发现:长期护理保险显著改善了老年人心理健康,且政策效应具有累积性。改善生活预期、减小健康支出压力和降低孤独感是长期护理保险改善老年人心理健康的重要作用机制。异质性政策效应评估结果表明,长期护理保险对老年人心理健康的影响效应在不同个体、家庭、地区和政策方案之间具有显著差异。中高龄、失能程度较高和家庭收入水平较低的老年人受长期护理保险影响更大。在老龄化程度较高、提供服务与现金补贴双重支持、以补偿形式进行待遇支付、设有医疗专护和职工与居民均被纳入参保范围的地区,长期护理保险的政策效应更强。文章建议扩大长期护理保险覆盖面,采取差异化政策,适当提高保障水平和支付力度,在服务项目中重视精神慰藉服务。Among all demographic groups in China,the elderly population has the highest suicide rate,making the mental health issues of the elderly a significant social challenge.This paper utilizes data from five waves of the China Health and Retirement Longitudinal Study(CHARLS)from 2011 to 2020,employing a progressive difference-in-differences model to empirically examine the impact and mechanisms of long-term care insurance on the mental health of the elderly.The study reveals that long-term care insurance significantly enhances the mental health of the elderly,with cumulative policy effects.Fundamental mechanisms include improving life expectancy,reducing the pressure of health expenditures,and alleviating feelings of loneliness.The evaluation of heterogeneous policy effects indicates that the impact of long-term care insurance on the mental health of the elderly varies significantly across different individuals,families,regions,and policy schemes.Elderly individuals who are older,have higher levels of disability,and lower family income benefit more from long-term care insurance.Regions with a higher degree of aging,dual support of services and cash subsidies,compensation-based benefit payments,specialized medical care,and inclusion of employees and residents in the insurance coverage demonstrate more substantial policy effects.The article recommends expanding long-term care i insurance coverage,adopting dfferentiated policies,increasing protection and payment levels,and providing spiritual comfort services.

关 键 词：老年人 心理健康 长期护理保险 社会支持理论 

分 类 号：R395.6[哲学宗教—心理学] F842.6[医药卫生—医学心理学]