长期护理保险对中老年群体家庭隔代照料的影响——基于CHARLS面板数据的实证分析  

Empirical Analysis of the Impact of Long-Term Care Insurance on Intergenerational Care in Middle-Aged and Elderly Families Based on CHARLS Panel Data

作　　者：倪子菡 朱秀媛 宋宝香 田侃[1] Ni Zihan(School of Elderly Care and Management,Nanjing University of Chinese Medicine,Nanjing,P.R.China)

机构地区：[1]南京中医药大学养老服务与管理学院,江苏南京210023 [2]南京中医药大学卫生经济管理学院 [3]江苏省习近平新时代中国特色社会主义思想研究中心南京中医药大学理论研究基地

出　　处：《中国卫生事业管理》2025年第2期162-167,共6页Chinese Health Service Management

基　　金：国家自然科学基金青年项目“数字健康时代新兴医疗信息技术使用对医生工作绩效的影响研究:基于适应性结构化理论的视角”(71702078);2024年江苏省经济专项课题“江苏支持探索长期护理保险制度的政策研究”(24CSB003);江苏省社科应用研究精品工程课题“江苏社区嵌入式医养结合养老模式研究”(22SYC-041)。

摘　　要：目的:探讨长期护理保险制度的实施对中老年群体家庭隔代照料的影响。方法:纳入2013和2018年中国健康与养老追踪调查(CHARLS)的17948名45岁及以上的中老年人作为研究对象,使用双重差分法(DID)考察长护险制度对中老年群体所在家庭照料孙辈的影响。结果:基准回归结果表明,长护险试点地区相对于非试点地区,中老年群体家庭隔代照料时间平均增加了1.372%。异质性分析发现,长护险制度对老年群体的家庭隔代照料时间具有显著的正向影响(P<0.01),而该影响在中年群体的家庭中不显著(P>0.05)。机制分析结果显示,子女向上经济支持在长护险影响中老年群体参与家庭隔代照料时长中起部分中介作用(P<0.01)。结论:中老年群体参加长期护理保险不仅会对个人产生积极影响,也会对其家庭成员产生溢出效应并进一步优化家庭资源分配。因此未来应从扩大制度覆盖范围、完善制度设计和提高保障水平、强化政策宣传以及增加家庭代际间支持等方面扩大长护险制度的积极作用。Objective To explore the impact of the implementation of long-term care insurance system on intergenerational care in middle-aged and elderly families.Methods 17,948 individuals aged 45 and above from the 2013 and 2018 China Health and Retirement Longitudinal Study(CHARLS)were taken as research objectives.The Difference-in-Differences(DID)method was used to examine the effect of the long-term care insurance system on caring for grandchildren by middle-aged and elderly families.Results Baseline regression results indicated that,compared to non-pilot areas,the average intergenerational caregiving time within middle-aged and elderly families in pilot areas increased by 1.372%.Heterogeneity analysis revealed that the long-term care insurance system has a significantly positive effect on the time elderly families spend on intergenerational care(P<0.01),which was not significant in middle-aged families(P>0.05).Mechanism analysis showed that upward economic support from children partially mediated the relationship between long-term care insurance and intergenerational care in middle-aged and elderly families(P<0.01).Conclusion Participation in long-term care insurance by middle-aged and elderly individuals not only benefits them directly,but also creates positive spillover effects for their family members,contributing to more efficient family resource allocation.To further enhance the positive impact of the long-term care insurance system,it is suggested to further expand its coverage,refine system design and benefit levels,strengthen policy promotion,and foster greater intergenerational family support.

关 键 词：长期护理保险 中老年 隔代照料 双重差分法 

分 类 号：R197[医药卫生—卫生事业管理] F842.6[医药卫生—公共卫生与预防医学] D669.6[经济管理—保险]