摘要
在我国老龄化程度持续加深背景下,失能老人数量不断增加,多个城市积极开展长期照护保险(以下简称长照险)制度试点建设,长照险实施能否助力实现健康老龄化战略目标成为社会和学界关注的焦点。本文利用2017—2021年某长照险制度试点城市申请人员数据以及回访数据,从两个层次考察长照险的健康价值。首先,采用精确断点回归模型,实证分析长照险实施对失能人员死亡率的影响。其次,通过对比申请调查和回访调查中日常生活活动能力评分的变化情况,分析政策实施对失能人员失能轨迹的影响。研究结果发现,长照险实施能显著降低失能人员死亡率、延长寿命,并有效延缓健康状况恶化进程。组间异质性分析发现,对中轻度失能人员进行早期干预十分必要。为此,本文建议试点城市应逐步构建从重度失能到健康的连续性健康养老服务体系,并为功能严重衰退的失能老人提供包含更多医疗健康相关的专业化社会支持上门服务。
Against the background of the continuous deepening of the aging degree in China,the number of disabled elderly continuous to increase,and several cities are actively carrying out the pilot long-term care insurance(LTCI)system,and whether the implementation of LTCI can help achieve the strategic goal of healthy aging has been the focus of social and academic attention.In this paper,the health value of LTCI is examined on two levels with the data of applicants in a pilot city of LTCI system from 2017 to 2021 as well as the data of return visits.First,a Sharp Regression Discontinuity model is used to empirically analyze the impact of LTCI implementation on the mortality of the disabled.Second,the impact of policy implementation on the disability trajectories of disabled persons is analyzed by comparing the changes in daily life ability scores in the application survey and the return survey.The results of the study finds that LTCI implementation significantly reduces the mortality of disabled persons,extends the lifespan,and effectively delays the deterioration of health status.Heterogeneity analysis between groups finds that early intervention for people with moderate to mild disability is necessary.The pilot cities should gradually build a continuous elderly health care service system from severe disability to good health,and provide specialized social support in-home services that include more medical and health-related services for the disabled elderly with severe functional retrogression.
作者
陈钰晓
赵绍阳
Chen Yuxiao;Zhao Shaoyang
出处
《统计研究》
CSSCI
北大核心
2024年第3期140-152,共13页
Statistical Research
基金
国家自然科学基金面上项目“临终前医疗支出水平及其经济效率的实证评价”(72273094)
国家社会科学基金重点项目“乡村振兴对县域治理能力的影响及对策研究”(23AZZ008)
教育部人文社会科学青年基金项目“基于机器学习方法的医保基金支出合规性识别及智慧监管策略研究”(23YJC790010)
教育部人文社会科学西部项目“门诊统筹的福利效应评估及政策优化研究”(23XJC790009)。
关键词
长期照护保险
健康价值
失能轨迹
断点回归
Long-term Care Insurance
Health Value
Disability Trajectory
Sharp Regression Discontinuity
