The Impact Of Long-term Care Insurance On The Utilization Of Medical Services For The Elderly

With the continuous development of China’s economy,the living standards of residents are generally improved,and the medical and health conditions are constantly improved.In this way,the average life expectancy of the people increases year by year,and the aging of population in China is deepening.Although population aging is the inevitable outcome of economic development and social progress,it affects the process of social and economic development.Improper handling of the aging problem will bring many challenges to the economy,society and people’s livelihood.Therefore,it is of great practical significance to discuss how to improve the medical care system of China and further promote the development of combining medical care with nursing care.With the acceleration of the aging process,the demand of the middle-aged and elderly disabled for long-term care services is gradually emerging.However,the improvement of living standards has changed the concept of the public greatly.The increase of female employment rate and the miniaturization of family size have prompted disabled families to abandon the traditional way of home care and seek another one.In this case,long-term care insurance came into being.In 2012,Qingdao took the lead in carrying out the pilot work of long-term care insurance,covering urban workers.In January 2015,the coverage was expanded to both workers and residents living in urban and rural.So far,the exploration of long-term care insurance in Qingdao has made some initial achievement,and Qingdao has become a working model for other pilot cities in China.Since 2012,the pilot work of long-term care insurance nationwide has been continuously promoted.In 2016,there were 15 pilot cities in China,and by the end of 2020,the number of pilot cities had reached 49 More and more residents have been covered by the long-term care insurance.This paper will identify and evaluate the policy effect of the long-term care insurance in Qingdao.Taking the middle-aged and elderly residents of Qingdao as the research objects,this paper adopts the DID model to measure whether there is difference in the medical treatment behavior and medical expenses in Qingdao after the implementation of the long-term care insurance.According to the empirical results,it can be found that the long-term care insurance significantly changes the medical frequency and medical burden of the middle-aged and elderly in Qingdao.The implementation of this system reduces the outpatient expenses by 192.41 yuan and the outpatient visits by 0.25 times per month.It also reduces hospitalization expenses by 1420.35 yuan and the frequency of hospitalization times by 0.18 times.In the robustness test,PSM-DID,placebo test with the special treatment group and screening of control groups are used in this paper to verify the robustness of DID results.The impact of long-term care insurance on middle-aged and elderly residents may be realized because of the increasing supply of nursing care that this system brings to us.The disabled elderly who only need care rather than treatment can choose home care,community care or living in professional nursing institutions to solve their nursing demands,rather than going to medical institutions to accept expensive services.The implementation of long-term care insurance effectively improves the utilization efficiency of medical resources and solves the problem named "social hospitalization",and it also can reduce the burden of medical expenses for disabled families.Long-term care insurance system in China,however,is still at the pilot stage.Compared with Germany,Japan and the United States,whose long-term care insurance systems are more mature,there are still many deficiencies in the coverage,qualification and financing ways of the long-term care insurance system in China.In response to these questions,there are some recommendations as follows:(1)Promote common development of social long-term care insurance and commercial insurance;(2)Expand the coverage of the insurance gradually;(3)Clear diversified financing channels and responsibilities;(4)Unify the national long-term care insurance rating standards;(5)Build an incentive mechanism for long-term care insurance.Accelerating the development of long-term care insurance is conducive to perfecting the social security system.It can improve the quality of life for the disabled,enhance the public’s well-being,and promote the social fairness and justice.