Drawing on four waves of nationally representative CHARLS data (2011–2018), this analysis evaluates whether China's pilot long-term care insurance program altered hospital service utilization, medical expenditures, and health status among older adults. The work tests a central premise of long-term care financing: that supported care outside the hospital can substitute for acute inpatient use. Its relevance to longevity lies in whether insured access to sustained, lower-intensity care changes the trajectory of functional decline in later life.
Key Points
- Evaluates China's pilot long-term care insurance using four CHARLS waves
- Outcomes examined: hospital utilization, medical spending, and health status
- Tests whether supported care substitutes for acute inpatient services
Longevity Analysis
Functional dependency in later life is rarely resolved in hospitals, yet acute care often absorbs demand that sustained, lower-intensity support would meet more effectively. Insurance structures that remove financial barriers to continuous care shift the setting in which decline is managed — relevant to how mobility, recovery capacity, and the physiological burden of repeated hospitalization unfold over years. Population-scale financing decisions therefore operate as a determinant of healthspan, not merely a cost-control mechanism, and their effects become visible only in longitudinal data of this kind.
Original published by SAGE Research on Aging, by Jing Liu, Heying Jenny Zhan, Weidong Dai, Wenwen Fu1School of Public Administration, 12623Zhejiang University of Finance and Economics, Hangzhou, China2Department of Sociology, Georgia State University, Atlanta, GA, USA.