关键词: 长期照护保险, 健康价值, 失能轨迹, 断点回归

Abstract: 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.

Key words: Long-term Care Insurance, Health Value, Disability Trajectory, Sharp Regression Discontinuity