长期护理保险对老年人社会参与的影响——基于CHARLS数据的实证研究  

Empirical Study on the Impact of Long-Term Care Insurance on the Social Participation of Older Adults Based on CHARLS Data

作　　者：沈宇芯 田侃[1] 喻小勇[1] Shen Yuxin(School of Elderly Care and Management,Nanjing University of Traditional 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

出　　处：《中国卫生事业管理》2025年第3期286-291,共6页Chinese Health Service Management

基　　金：国家社科基金青年项目“‘医联体’内健康服务协同供给机制及其医保激励”(19CGL063);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);南京中医药大学哲学社会科学项目“江苏长期护理保险制度可持续性及其优化研究”(24XRC008);江苏省卫生健康事业发展专项“卫生监督调研相关工作研究”。

摘　　要：目的:探讨长期护理保险对老年人社会参与的影响,为完善长期护理保险政策和提升老年人的健康福祉提供依据。方法:基于2013、2015和2018年的中国健康和养老追踪调查(CHARLS)三期面板数据,采用倾向得分匹配-双重差分(PSM-DID)方法进行实证分析。结果:基准回归结果表明,长期护理保险显著提升了老年人的社会参与水平,相比未参保长护险的老年人,参保长护险的老年人社会参与强度平均提高0.216个单位。机制分析显示,自评健康在长护险与社会参与之间起到了部分中介作用,即长护险政策的实施通过改善健康状况,进而提高了老年人的社会参与水平。异质性分析发现,长期护理保险对社会参与的正向影响在女性、农村户口和低龄老年人群体中尤为显著。结论:提出拓展长护险受益群体,结合健康管理服务,实施差异化护理服务和探索“护理+社会参与”创新服务模式等建议,以期进一步优化长期护理保险制度。Objective To explore the impact of long-term care insurance on the social participation of the older adults,and provide evidence for the improvement of long-term care insurance policies and the enhancement of their health and well-being.Methods Based on the panel data from the China Health and Retirement Longitudinal Study(CHARLS)in 2013,2015,and 2018,the propensity score matching-difference-in-differences(PSM-DID)method was employed for empirical analysis.Results The baseline regression results indicated that long-term care insurance significantly enhanced the social participation level of the older adults.Compared to older adults who were not insured under long-term care insurance,those who were insured showed an average increase of 0.216 units in social participation intensity.Mechanism analysis revealed that self-rated health played a partial mediating role between long-term care insurance and social participation.The implementation of long-term care insurance policies increased social participation among the older adults by improving their health status.Heterogeneity analysis found that the positive impact of long-term care insurance on social participation was particularly significant among women,rural residents,and younger older adults.Conclusion It is suggested to expand the beneficiary group of long-term care insurance,integrate health management services,implement differentiated nursing services,and explore the innovative"care+social participation"service models to further optimize the long-term care insurance system.

关 键 词：长期护理保险 老年人 社会参与 PSM-DID 

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]