Long-term care insurance and the well-being of older adults and their families: Evidence from China

This paper examines the impact of China's public long-term care insurance (LTCI) pilots on the well-being of older adults and their families. Using panel data from the Chinese Longitudinal Healthy Longevity Survey, we exploit the rollout of the LTCI pilots across different cities during 2015–2017 and identify the effect of LTCI using a difference-in-differences approach. We find that the implementation of LTCI has reduced the likelihood of older adults reporting unmet activity of daily living (ADL)–related need for care, the intensity of informal care, and the amounts of ADL-related care expenditures and out-of-pocket medical expenditures. LTCI coverage was also associated with an improvement in self-reported health and a reduction in one-year mortality risk of older adults with baseline need for care. From a policy perspective, these findings suggest that the introduction of LTCI may benefit all members of the household, both care recipient and caregivers, which has important implications for the development of LTCI in China and other middle-income and developing countries.