The Impact of Long-Term Care Insurance on Household Expenditures of the Elderly: Evidence from China

The Impact of Long-Term Care Insurance on Household Expenditures of the Elderly: Evidence from China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The Impact of Long-Term Care Insurance on Household Expenditures of the Elderly: Evidence from China Zeping Hu, Tianshu Zhang, Kaiyue Zhang, Xinran Li This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4730498/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study aims to investigate the impact of China’s long-term care insurance (LTCI) pilot on household expenditures of the elderly. Utilizing the China Health and Retirement Longitudinal Study (CHARLS) 2015–2020 three-period longitudinal panel data, we examine the policy effects of LTCI using the Differences-in-Differences(DID) approach. The results indicate that the implementation of LTCI significantly reduces medical (p < 0.05) and healthcare expenditures (p < 0.05) for elderly households, while substantially increasing non-medical healthcare expenditures (p < 0.01) and total expenditures (p < 0.01). This effect is more pronounced for older households in rural areas or with lower levels of education. Furthermore, the improvement in household expenditures is strongly associated with the health status of the elderly and intergenerational economic support. These findings provide empirical evidence that LTCI enhances household expenditures and the quality of life for the elderly, which is crucial for the development of LTCI in China and other middle-income developing countries. long-term care insurance China household expenditures of the elderly DID Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4730498","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":336882958,"identity":"6d86348d-1a35-422d-bff9-6e4bcc309199","order_by":0,"name":"Zeping Hu","email":"","orcid":"","institution":"Inner Mongolia University of Finance and Economics","correspondingAuthor":false,"prefix":"","firstName":"Zeping","middleName":"","lastName":"Hu","suffix":""},{"id":336882959,"identity":"6d7a5b41-ff0c-4b4c-86b5-ef6dcff1136a","order_by":1,"name":"Tianshu Zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCklEQVRIiWNgGAWjYDACCTjJw8D4wYBNjo29+QARWhIgWpglCviM+XiOJRCjhQGshYHng1ziPIkcBbw65Gc3P3v49YeFvDn/2WMSEgZm6W0MOQwMPyq24dTCOOeYubFMgoThzhl5aRIFBmm5bQxnDzD2nLmNUwuzRIKZtESCBOOGGzxmQFuO5bYx9iUwM7bh1sImkf4NpMV+w/kzZhI8Bv/T2Zh5DPBq4ZHIMZP8kCCRuOFADkgLWwIbGwEtEhI5ZdIMaRLJG27kGFtLGLAZtvGwJRzE5xf5GenbJH/Y1NkCHWZ488MfNnn5+Y8PPvhRgVsLOAh40EUO4FUPBIw/CKkYBaNgFIyCkQ0AVBdO6yGyydMAAAAASUVORK5CYII=","orcid":"","institution":"Inner Mongolia University of Finance and Economics","correspondingAuthor":true,"prefix":"","firstName":"Tianshu","middleName":"","lastName":"Zhang","suffix":""},{"id":336882960,"identity":"0b7a18c0-d73e-48b8-ace8-d495e21fc688","order_by":2,"name":"Kaiyue Zhang","email":"","orcid":"","institution":"Inner Mongolia University of Finance and Economics","correspondingAuthor":false,"prefix":"","firstName":"Kaiyue","middleName":"","lastName":"Zhang","suffix":""},{"id":336882961,"identity":"e7cb9fa6-3d1f-47f3-a4c2-ec147e82fa7c","order_by":3,"name":"Xinran Li","email":"","orcid":"","institution":"Inner Mongolia University of Finance and Economics","correspondingAuthor":false,"prefix":"","firstName":"Xinran","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2024-07-12 13:08:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4730498/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4730498/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":67768786,"identity":"4a692d5c-3a32-4a2d-809b-3e81f561058a","added_by":"auto","created_at":"2024-10-29 13:39:31","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":625220,"visible":true,"origin":"","legend":"","description":"","filename":"Longtermcareinsuranceandhouseholdexpendituresoftheelderly.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4730498/v1_covered_4434ea19-e1c7-4b16-bee4-97020c28e542.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Impact of Long-Term Care Insurance on Household Expenditures of the Elderly: Evidence from China","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"long-term care insurance, China, household expenditures of the elderly, DID","lastPublishedDoi":"10.21203/rs.3.rs-4730498/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4730498/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study aims to investigate the impact of China\u0026rsquo;s long-term care insurance (LTCI) pilot on household expenditures of the elderly. Utilizing the China Health and Retirement Longitudinal Study (CHARLS) 2015\u0026ndash;2020 three-period longitudinal panel data, we examine the policy effects of LTCI using the Differences-in-Differences(DID) approach. The results indicate that the implementation of LTCI significantly reduces medical (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and healthcare expenditures (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) for elderly households, while substantially increasing non-medical healthcare expenditures (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and total expenditures (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). This effect is more pronounced for older households in rural areas or with lower levels of education. Furthermore, the improvement in household expenditures is strongly associated with the health status of the elderly and intergenerational economic support. 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