IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2022i1p192-d1012473.html
   My bibliography  Save this article

Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health

Author

Listed:
  • Guangbo Ma

    (Institute of Finance and Public Management, Anhui University of Finance and Economics, Bengbu 233030, China)

  • Kun Xu

    (Institute of Finance and Public Management, Anhui University of Finance and Economics, Bengbu 233030, China)

Abstract

Long-term care insurance (LTCI) is a significant approach in the effort to actively manage aging and the currently unmet need for aged care in China. Based on data from the 2011, 2013, 2015, and 2018 phases of the China Health and Retirement Longitudinal Study, we used the propensity score matching-difference in difference (PSM-DID) approach to explore the impact of LTCI on out-of-pocket medical expenses and self-rated health. Results showed that LTCI can significantly reduce out-of-pocket medical expenses by 37.16% ( p < 0.01) per year and improve self-rated health by 5.73% ( p < 0.01), which conforms to the spirit of “value-based health care”. The results were found to be stable in the robustness tests conducted. Currently, China is at the intersection of “low-value-based health care” and “value-based health care”. Improving the health level of aged individuals while keeping medical costs under reasonable control is crucial for formulating and implementing a new round of healthcare reform in China.

Suggested Citation

  • Guangbo Ma & Kun Xu, 2022. "Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health," IJERPH, MDPI, vol. 20(1), pages 1-20, December.
    • Handle: RePEc:gam:jijerp:v:20:y:2022:i:1:p:192-:d:1012473
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/1/192/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/20/1/192/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Ami Ko, 2022. "An Equilibrium Analysis of the Long-Term Care Insurance Market," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 89(4), pages 1993-2025.
    2. Fernando Bermejo & Raúl del Pozo & Pablo Moya, 2021. "Main Factors Determining the Economic Production Sustained by Public Long-Term Care Spending in Spain," IJERPH, MDPI, vol. 18(17), pages 1-18, August.
    3. Joan COSTA‐FONT & Christophe Courbage & Katherine Swartz, 2015. "Financing Long‐Term Care: Ex Ante, Ex Post or Both?," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 45-57, March.
    4. Brown, Jeffrey R. & Finkelstein, Amy, 2007. "Why is the market for long-term care insurance so small?," Journal of Public Economics, Elsevier, vol. 91(10), pages 1967-1991, November.
    5. Jianwen Wei & Jie Zhang & Yuping Deng & Long Sun & Ping Guo, 2018. "Suicidal Ideation among the Chinese Elderly and Its Correlates: A Comparison between the Rural and Urban Populations," IJERPH, MDPI, vol. 15(3), pages 1-10, February.
    6. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    7. Weidong Dai, 2019. "Is China facing the social risks associated with reliance on hospitalization for the care of the elderly with chronic diseases?," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(2), pages 794-805, April.
    8. Van Houtven, Courtney Harold & Coe, Norma B. & Skira, Meghan M., 2013. "The effect of informal care on work and wages," Journal of Health Economics, Elsevier, vol. 32(1), pages 240-252.
    9. Papanicolas, Irene & Woskie, Liana R. & Jha, Ashish K., 2018. "Health care spending in the United States and other high-income countries," LSE Research Online Documents on Economics 87362, London School of Economics and Political Science, LSE Library.
    10. Costa-Font, Joan & Jimenez-Martin, Sergi & Vilaplana, Cristina, 2018. "Does long-term care subsidization reduce hospital admissions and utilization?," Journal of Health Economics, Elsevier, vol. 58(C), pages 43-66.
    11. Maria M. Hofmarcher & Howard Oxley & Elena Rusticelli, 2007. "Improved Health System Performance through better Care Coordination," OECD Health Working Papers 30, OECD Publishing.
    12. Feng, Tong & Du, Huibin & Coffman, D'Maris & Qu, Aiyu & Dong, Zhanfeng, 2021. "Clean heating and heating poverty: A perspective based on cost-benefit analysis," Energy Policy, Elsevier, vol. 152(C).
    13. Ye Han & Tong Shen, 2022. "Long-Term Care Insurance Pilot Programme in China: Policy Evaluation and Optimization Options—Taking the Pilot Programme in the Northeast of China as an Example," IJERPH, MDPI, vol. 19(7), pages 1-18, April.
    14. Xiaokai Yang & Robert Rice, 2006. "An Equilibrium Model Endogenizing The Emergence Of A Dual Structure Between The Urban And Rural Sectors," World Scientific Book Chapters, in: Christis Tombazos & Xiaokai Yang (ed.), Inframarginal Contributions To Development Economics, chapter 8, pages 167-194, World Scientific Publishing Co. Pte. Ltd..
    15. Sumit Agarwal & Wenlan Qian, 2014. "Consumption and Debt Response to Unanticipated Income Shocks: Evidence from a Natural Experiment in Singapore," American Economic Review, American Economic Association, vol. 104(12), pages 4205-4230, December.
    16. Kim, Hyuncheol Bryant & Lim, Wilfredo, 2015. "Long-term care insurance, informal care, and medical expenditures," Journal of Public Economics, Elsevier, vol. 125(C), pages 128-142.
    17. Julien Forder, 2009. "Long‐term care and hospital utilisation by older people: an analysis of substitution rates," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1322-1338, November.
    18. William J. Scanlon, 1992. "Possible Reforms for Financing Long-Term Care," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 43-58, Summer.
    19. Strauss, John & Lei, Xiaoyan & Park, Albert & Shen, Yan & Smith, James P. & Yang, Zhe & Zhao, Yaohui, 2010. "Health Outcomes and Socio-Economic Status among the Elderly in China: Evidence from the CHARLS Pilot," IZA Discussion Papers 5152, Institute of Labor Economics (IZA).
    20. Fu, Rong & Noguchi, Haruko & Kawamura, Akira & Takahashi, Hideto & Tamiya, Nanako, 2017. "Spillover effect of Japanese long-term care insurance as an employment promotion policy for family caregivers," Journal of Health Economics, Elsevier, vol. 56(C), pages 103-112.
    21. Andreas Olden & Jarle Møen, 2022. "The triple difference estimator [Semiparametric difference-in-differences estimators]," The Econometrics Journal, Royal Economic Society, vol. 25(3), pages 531-553.
    22. McKnight, Robin, 2006. "Home care reimbursement, long-term care utilization, and health outcomes," Journal of Public Economics, Elsevier, vol. 90(1-2), pages 293-323, January.
    23. Marianne Tenand & Pieter Bakx & Eddy van Doorslaer, 2020. "Equal long‐term care for equal needs with universal and comprehensive coverage? An assessment using Dutch administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 435-451, April.
    24. Kim, Hoolda & Mitra, Sophie, 2022. "The Economic and Health Effects of Long-Term Care Insurance: New Evidence from Korea," The Journal of the Economics of Ageing, Elsevier, vol. 23(C).
    25. Kim, Hongsoo & Kwon, Soonman, 2021. "A decade of public long-term care insurance in South Korea: Policy lessons for aging countries," Health Policy, Elsevier, vol. 125(1), pages 22-26.
    26. Ricardo Rodrigues & Stefania Ilinca & Andrea E. Schmidt, 2018. "Income‐rich and wealth‐poor? The impact of measures of socio‐economic status in the analysis of the distribution of long‐term care use among older people," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 637-646, March.
    27. James Gaughan & Hugh Gravelle & Luigi Siciliani, 2015. "Testing the Bed‐Blocking Hypothesis: Does Nursing and Care Home Supply Reduce Delayed Hospital Discharges?," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 32-44, March.
    28. repec:ran:wpaper:774 is not listed on IDEAS
    29. Honsoo Kim & Soojin Kim & Wonshik Kim & Kyung Hoon Yang, 2022. "Dynamic Effects of Long-Term Care Insurance on Healthcare Expenditures: Evidence from South Korea," International Center for Public Policy Working Paper Series, at AYSPS, GSU paper2209, International Center for Public Policy, Andrew Young School of Policy Studies, Georgia State University.
    30. Michael G. Palumbo, 1999. "Uncertain Medical Expenses and Precautionary Saving Near the End of the Life Cycle," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 66(2), pages 395-421.
    31. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
    32. David Byrne & Michelle S. Goeree & Bridget Hiedemann & Steven Stern, 2009. "Formal Home Health Care, Informal Care, And Family Decision Making," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 50(4), pages 1205-1242, November.
    33. Schmitz, Hendrik & Westphal, Matthias, 2015. "Short- and medium-term effects of informal care provision on female caregivers’ health," Journal of Health Economics, Elsevier, vol. 42(C), pages 174-185.
    34. Jonathan Roth, 2022. "Pretest with Caution: Event-Study Estimates after Testing for Parallel Trends," American Economic Review: Insights, American Economic Association, vol. 4(3), pages 305-322, September.
    35. Xueqin Deng & Jiaxin Liao & Rong Peng & Jiahao Chen, 2022. "The Impact of Long-Term Care Insurance on Medical Utilization and Expenditures: Evidence from Jingmen, China," IJERPH, MDPI, vol. 19(19), pages 1-18, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Feng, Jin & Wang, Zhen & Yu, Yangyang, 2020. "Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China," Social Science & Medicine, Elsevier, vol. 258(C).
    2. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    3. Moura, Ana, 2022. "Do subsidized nursing homes and home care teams reduce hospital bed-blocking? Evidence from Portugal," Journal of Health Economics, Elsevier, vol. 84(C).
    4. Nicolas R. Ziebarth, 2018. "Social Insurance and Health," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 57-84, Emerald Group Publishing Limited.
    5. Coe, Norma B. & Goda, Gopi Shah & Van Houtven, Courtney Harold, 2023. "Family spillovers and long-term care insurance," Journal of Health Economics, Elsevier, vol. 90(C).
    6. Crawford, Rowena & Stoye, George & Zaranko, Ben, 2021. "Long-term care spending and hospital use among the older population in England," Journal of Health Economics, Elsevier, vol. 78(C).
    7. Liu, Hong & Ma, Jinqiu & Zhao, Liqiu, 2023. "Public long-term care insurance and consumption of elderly households: Evidence from China," Journal of Health Economics, Elsevier, vol. 90(C).
    8. Long Xia & Lulu Chai & Hanyu Zhang & Zhaohui Sun, 2022. "Mapping the Global Landscape of Long-Term Care Insurance Research: A Scientometric Analysis," IJERPH, MDPI, vol. 19(12), pages 1-19, June.
    9. Moura, Ana, 2021. "Essays in health economics," Other publications TiSEM c93abd22-fa4a-42a5-b172-d, Tilburg University, School of Economics and Management.
    10. Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy & Wong, Albert, 2020. "Better off at home? Effects of nursing home eligibility on costs, hospitalizations and survival," Journal of Health Economics, Elsevier, vol. 73(C).
    11. Rellstab, Sara & Bakx, Pieter & García-Gómez, Pilar & van Doorslaer, Eddy, 2020. "The kids are alright - labour market effects of unexpected parental hospitalisations in the Netherlands," Journal of Health Economics, Elsevier, vol. 69(C).
    12. Hollingsworth, Bruce & Ohinata, Asako & Picchio, Matteo & Walker, Ian, 2022. "Does It Matter Who Cares for You? The Effect of Substituting Informal with Formal Personal Care on the Care Recipients' Health," IZA Discussion Papers 15457, Institute of Labor Economics (IZA).
    13. Amitabh Chandra & Courtney Coile & Corina Mommaerts, 2023. "What Can Economics Say about Alzheimer's Disease?," Journal of Economic Literature, American Economic Association, vol. 61(2), pages 428-470, June.
    14. Brendan Walsh & Seán Lyons & Samantha Smith & Maev‐Ann Wren & James Eighan & Edgar Morgenroth, 2020. "Does formal home care reduce inpatient length of stay?," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1620-1636, December.
    15. Meghan M. Skira, 2015. "Dynamic Wage And Employment Effects Of Elder Parent Care," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 56(1), pages 63-93, February.
    16. Costa-Font, Joan & Jiménez-Martín, Sergi & Vilaplana-Prieto, Cristina, 2022. "Do Public Caregiving Subsidies and Supports affect the Provision of Care and Transfers?," Journal of Health Economics, Elsevier, vol. 84(C).
    17. Ozbugday, Fatih Cemil & Tirgil, Abdullah & Kose, Elif Gul, 2020. "Efficiency changes in long-term care in OECD countries: A non-parametric Malmquist Index approach," Socio-Economic Planning Sciences, Elsevier, vol. 70(C).
    18. Kim, Hoolda & Mitra, Sophie, 2022. "The Economic and Health Effects of Long-Term Care Insurance: New Evidence from Korea," The Journal of the Economics of Ageing, Elsevier, vol. 23(C).
    19. Walsh, Brendan & Wren, Maev-Ann & Smith, Samantha & Lyons, Seán & Eighan, James & Morgenroth, Edgar, 2019. "An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital," Research Series, Economic and Social Research Institute (ESRI), number RS91, June.
    20. Julien Forder & Katerina Gousia & Eirini-Christina Saloniki, 2019. "The impact of long-term care on primary care doctor consultations for people over 75 years," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 375-387, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:20:y:2022:i:1:p:192-:d:1012473. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.