An Analysis of the Effects of Social Long-Term Care Insurance on the Financial Vulnerability of Middle-Aged and Elderly Households

Abstract

Abstract: Based on the panel data from the China Elderly Care and Health Tracking Survey from 2011 to 2020, this paper adopts a multi period double difference model to evaluate the impact of social long-term care insurance on the financial vulnerability risk of middle-aged and elderly households. The findings show that social long-term care insurance can significantly improve the financial vulnerability of middle-aged and elderly families, reducing the probability of financial vulnerability of those families by 2.6%. The impact of social long-term care insurance on the financial vulnerability of middle-aged and elderly families varies by region, health status, and income level. Social long-term care insurance can effectively alleviate the financial vulnerability of middle-aged and elderly families through three ways: reducing medical burden, increasing family labor participation rate, and improving living expectations. Based on this, it is suggested to further expand the coverage of social long-term care insurance on the basis of the pilot projects in the early stage. While promoting the “family participation+social security” service model, it is also necessary to enhance the risk management awareness of the family members and gradually build an insurance mechanism that adapts to social progress and the economic affordability of all parties.

Key words: social long-term care insurance, family financial vulnerability, medical burden, labour participation rate

CLC Number:

F840

Yan Yong, Jing Tao. An Analysis of the Effects of Social Long-Term Care Insurance on the Financial Vulnerability of Middle-Aged and Elderly Households[J]. Journal of Jiangxi University of Finance and Economics, 2025, 0(2): 57-72.

References

[1] 艾静怡, 彭希哲. 长期护理保险对家庭成员劳动供给的影响[J]. 保险研究, 2024, (5): 73-84.
[2] 陈飞, 王若同. 长期护理保险制度的共同富裕效应:基于照护决策与风险分担视角[J]. 世界经济, 2024, (4): 154-183.
[3] 马超, 俞沁雯, 宋泽, 等. 长期护理保险、医疗费用控制与价值医疗[J]. 中国工业经济, 2019, (12): 42-59.
[4] 沈冰清, 郭忠兴. 新农保改善了农村低收入家庭的脆弱性吗?——基于分阶段的分析[J]. 中国农村经济, 2018, (1): 90-107.
[5] 苏会, 王琳, 刘华. 长期护理保险政策:本质特征、实施效果与溢出效应——基于试点城市南通市Z区的考察[J]. 江西财经大学学报, 2024, (3): 64-77.
[6] 汤薇, 虞幸然, 粟芳. 长期护理保险对城乡居民医疗保险财政负担的影响——基于地区视角和替代效应[J]. 江西财经大学学报, 2023, (6): 40-55.
[7] 于新亮, 刘慧敏, 杨文生. 长期护理保险对医疗费用的影响——基于青岛模式的合成控制研究[J]. 保险研究, 2019, (2): 114-127.
[8] 袁礼, 周正. 环境权益交易市场与企业绿色专利再配置[J]. 中国工业经济, 2022, (12): 127-145.
[9] 岳崴, 王雄, 张强. 健康风险、医疗保险与家庭财务脆弱性[J]. 中国工业经济, 2021, (10): 175-192.
[10] 张冀, 祝伟, 王亚柯. 家庭经济脆弱性与风险规避[J]. 经济研究, 2016, (6): 157-171.
[11] 朱铭来, 何敏, 马智苏. 长期护理保险的模式选择与体系构建研究[J]. 中国人口科学, 2023a, (1): 3-20.
[12] 朱铭来, 申宇鹏, 康琢. 失能风险、长期护理保险与家庭持久性贫困[J]. 经济学动态, 2023b, (9): 111-130.
[13] Albacete N, Lindner P.Household vulnerability in Austria—A microeconomic analysis based on the household finance and consumption survey[J]. Financial Stability Report, 2013, 25: 57-73.
[14] Ampudia M, Van Vlokhoven H, ochowski D. Financial fragility of euro area households[J]. Journal of Financial Stability, 2016, 27: 250-262.
[15] Borusyak K, Jaravel, Spiess J.Revisiting event-study designs: Robust and efficient estimation[J]. Review of Economic Studies, 2024: 91(6): 3253-3285.
[16] Brunetti M, Giarda E, Torricelli C.Is financial fragility a matter of illiquidity? An appraisal for Italian households[J]. Review of Income and Wealth, 2016, 62(4): 628-649.
[17] Callaway B, Sant’Anna P H C. Difference-in-differences with multiple time periods[J]. Journal of Econometrics, 2021, 225(2): 200-230.
[18] Costa-Font J, Vilaplana-Prieto C.Does the expansion of public long-term care funding affect saving behaviour?[J]. Fiscal Studies, 2017, 38(3): 417-443.
[19] Fajgelbaum P D, Goldberg K P, Kennedy J P, et al.The return to protectionism[J]. The Quarterly Journal of Economics, 2020, 135(1): 1-55.
[20] Feng J, Wang Z, Yu Y Y.Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China[J]. Social Science & Medicine, 2020, 258: 113081.
[21] Forder J.Long-term care and hospital utilisation by older people: An analysis of substitution rates[J]. Health Economics, 2009, 18(11): 1322-1338.
[22] Gathergood J.Self-control, financial literacy and consumer over-indebtedness[J]. Journal of Economic Psychology, 2012, 33(3): 590-602.
[23] Gaughan J, Gravelle H, Siciliani L.Testing the bed-blocking hypothesis: Does nursing and care home supply reduce delayed hospital discharges?[J]. Health Economics, 2015, 24: 32-44.
[24] Greenhalgh-Stanley N.Are the elderly responsive in their savings behavior to changes in asset limits for Medicaid?[J]. Public Finance Review, 2015, 43(3): 324-346.
[25] Jappelli T, Pagano M, Di Maggio M.Households’ indebtedness and financial fragility[J]. Journal of Financial Management, Markets and Institutions, 2013, 1(1): 23-46.
[26] Kim H B, Lim W.Long-term care insurance, informal care, and medical expenditures[J]. Journal of Public Economics, 2015, 125: 128-142.
[27] Liu H, Ma J Q, Zhao L Q.Public long-term care insurance and consumption of elderly households: evidence from China[J]. Journal of Health Economics, 2023, 90: 102759.
[28] Lusardi A, Mitchell O S, Oggero N.Debt and financial vulnerability on the verge of retirement[J]. Journal of Money, Credit and Banking, 2020, 52(5): 1005-1034.
[29] Zhou M G, Wang H D, Zhu J, et al.Cause-specific mortality for 240 causes in China during 1990-2013: A systematic subnational analysis for the Global Burden of Disease Study 2013[J]. The Lancet, 2016, 387(10015): 251-272.
[30] Zuchandke A, Reddemann S, Krummaker S, et al.Impact of the introduction of the social long-term care insurance in Germany on financial security assessment in case of long-term care need[J]. The Geneva Papers on Risk and Insurance-Issues and Practice, 2010, 35: 626-643.