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      Evaluating the long-term care insurance policy from medical expenses and health security equity perspective: evidence from China


      1 , , 2

      Archives of Public Health

      BioMed Central

      Long-term care insurance, Disability, Medical expenses, Health level, DID

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          Since the national long-term care (LTCI) policy pilot in 2016 of China, the LTCI policy has had significant impact on the residents in the pilot area.


          From the perspective of medical expenses and health security equity, this study selects tracking survey data from the CHARLS database in 2013, 2015, and 2018 and empirically investigates the effect of LTCI policy pilot by using differences-in-differences method (DID). Moreover, this study measures the economic distribution and health equity of the treated and untreated groups using the concentration and Theil indices.


          The results showed that group heterogeneity of medical expenses and health level of elderly in the treatment group were narrowing. Moreover, the policy results showed that the LTCI policy pilot significantly affects the outpatient, hospital expenses, and length of stay of elders. Residence registration, income level, and basic medical insurance play a significant regulatory role. Additionally, LTCI policy pilot significantly improved the overall health of the elderly.


          The measurement results of inequality show that the policy increases the income of low-income people, lowers the inequality level of outpatient and inpatient reimbursement, and reduces the concentration index of ADL disability and serious diseases. However, the inequality of serious diseases is becoming higher. Based on this, this paper provides several suggestions on optimizing the pilot policy of LTCI.

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          Most cited references34

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          A research agenda for aging in China in the 21st century

          Highlights • The elderly population in China is growing exponentially and this growth will last for decades. • The aging problem in China is expected to lead to a significant socioeconomic burden which will require a combined effort among gerontologists, healthcare professionals, policymakers, and social forces. • A research agenda on the collection of public health data, diet and food safety, physical exercise, pharmacological interventions in age associated diseases, the elderly and geriatric care, and policy dialogues are potential ways to relieve the aging problem. • Increased political and financial commitments from the Chinese government are critical for achieving a research agenda on aging in China for the 21st century.
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              Health care expenditure and income in the OECD reconsidered: Evidence from panel data


                Author and article information

                Arch Public Health
                Arch Public Health
                Archives of Public Health
                BioMed Central (London )
                4 January 2022
                4 January 2022
                : 80
                [1 ]GRID grid.463102.2, ISNI 0000 0004 1761 3129, Zhejiang University of Finance & Economics, ; Hang Zhou, China
                [2 ]GRID grid.49470.3e, ISNI 0000 0001 2331 6153, Wuhan University, ; Wuhan, China
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                Funded by: Zhejiang Philosophy and Social Science Planning Project
                Award ID: 20NDQN302YB
                Award Recipient :
                Funded by: National Natural Science Fund of China
                Award ID: 71904167
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100004731, Natural Science Foundation of Zhejiang Province;
                Award ID: LQ20G030018
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                © The Author(s) 2022

                Public health

                long-term care insurance, disability, medical expenses, health level, did


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