长期护理保险对老年人灾难性卫生支出的影响研究  

A Study on the Impact of Long-term Care Insurance on Catastrophic Health Expenditures for Older People

作　　者：谢明明 杨洁 谢鑫 XIE Mingming;YANG Jie;XIE Xin(School of Business,Zhengzhou University,Zhengzhou 450001,China)

机构地区：[1]郑州大学商学院,河南郑州450001

出　　处：《人口与发展》2024年第4期156-166,共11页Population and Development

基　　金：国家社会科学基金青年项目“相对贫困视角下医疗保障化解支出型贫困的机理与政策优化研究”(20CSH029)。

摘　　要：失能老人的高额护理费用会导致家庭面临灾难性卫生支出和贫困脆弱性风险。研究利用2013—2018年中国健康与养老追踪调查(CHARLS)三期面板数据,采用双重差分模型(DID)实证检验了长期护理保险政策实施对老年人灾难性卫生支出的影响。研究发现:(1)长期护理保险可以减轻老年人发生灾难性卫生支出的概率和强度;(2)机制分析表明,长期护理保险可以通过提高老年人健康水平和增加家庭收入对灾难性卫生支出发生率发挥抑制作用;(3)异质性分析结果显示,长期护理保险对老年人灾难性卫生支出的缓解作用在中高健康水平、慢性病患者和农村样本中更为显著。最后,从扩大长期护理保险制度试点覆盖范围、拓宽长期护理保险覆盖对象、以灾难性卫生支出为依据,在长期护理保险政策框架中引入更为准确的医疗费用识别标准、推进社会性和商业长期护理保险协同发展等方面提出政策建议,丰富了长期护理保险对灾难性卫生支出影响的相关研究。The high cost of care for disabled older people can lead to catastrophic health expenditures and poverty vulnerability risks for families.Using CHARLS data from 2013 to 2018 for empirical analysis,this paper empirically tested the impact of long-term care insurance policy implementation on catastrophic health expenditures for older people using the Difference-in-Differences(DID)model.The study found that:(1)long-term care insurance can reduce the probability and intensity of catastrophic health expenditures for older people;(2)Mechanism analysis shows that long-term care insurance can reduce the incidence of catastrophic health expenditures by improving the health of older people and increasing household income;(3)The heterogeneity analysis shows that the relief effect of long-term care insurance on catastrophic health expenditures for older people is more significant in those with middle to high health levels,chronic disease patients,and rural samples.Finally,it proposes policy suggestions on expanding the pilot coverage of the long-term care insurance system,broadening the coverage of long-term care insurance,introducing more accurate medical expense identification standards into the long-term care insurance policy framework based on catastrophic health expenditures,and promoting the coordinated development of social and commercial long-term care insurance,and other related aspects.This paper enriches the relevant research on the impact of long-term care insurance on catastrophic health expenditures.

关 键 词：长期护理保险 老年人 灾难性卫生支出 

分 类 号：F840.61[经济管理—保险]