ArticleFrontiers in public health2025
Impact of Long-Term Care Insurance on health out-of-pocket expenditure ratios for older adults.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Perceived experiences of long-term care services among long-term care insurance beneficiaries and their family members: A qualitative interview study in Hunan Province, China.International journal of nursing sciences · 2026Article
- From individual burden to social risk pooling: drivers of the declining out-of-pocket health expenditure share in China (2009-2024).International journal for equity in health · 2026Article
- Institutionalizing family care responsibility in China's multilevel medical security system: evidence from long-term care insurance policy texts through a Confucian care ethics lens.Frontiers in public health · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: China's rapidly aging population has intensified the demand for long-term care (LTC), resulting in higher out-of-pocket expenditure (OOPE) ratios and financial strain among older adults. To mitigate these burdens, Long-Term Care Insurance (LTCI) has been piloted across selected cities. However, its effectiveness in reducing financial burden-particularly OOPE ratios-remains insufficiently evaluated. This study assesses the causal impact of LTCI on OOPE ratios and explores subgroup heterogeneity. Methods: We used panel data from the China Health and Retirement Longitudinal Study (CHARLS, 2015-2020), applying difference-in-differences (DID), dynamic DID, and propensity score matching DID (PSM-DID) approaches. The treatment group consisted of older adults living in 12 LTCI pilot cities, while controls were drawn from non-pilot areas. We adjusted for socio-demographic and health covariates and conducted robustness and parallel trend tests. Results: DID results show that LTCI significantly reduced OOPE ratios ( Conclusions: While LTCI has demonstrable short-term benefits in reducing OOPE ratios and improving equity, long-term sustainability remains at risk due to persistent cost escalation. Targeted policy design and enhanced integration with broader health financing mechanisms are needed to strengthen its long-term impact.
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