中国经济问题 ›› 2025›› Issue (05): 154-.

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现金给付式长期护理保险的迎合效应与健康效应———基于行政大数据的实证分析

  

  • 出版日期:2025-10-15 发布日期:2025-11-27

  • Online:2025-10-15 Published:2025-11-27

摘要: 在医保基金收支平衡和健康老龄化的双重目标下总结现有长期护理保险 (简称长护险”) 试点实践为我国长护险制度进一步向全国推广提供科学、严谨的经验证据具有重大意义本文使用长护险试点城市成都的行政大数据研究了现金给付式长护险的迎合效应与健康效应主要发现有:(1动态双重差分估计结果表明在现金给付的长护险待遇模式下申请人员在事前存在迎合效应即申请前通过低成本的过度住院行为来增加其获得现金补贴的可能性;(2进一步构造的动态三重差分模型显示健康效应使失能人员住院率下降了 5.8 个百分点月度住院总费用下降了 52.3%(3异质性分析发现健康效应更多体现在拥有居家照护供给者、失能程度较低且收入水平较低的失能群体本文检验了现金给付式长护险待遇模式的不足 (迎合效应) 和优势 (健康效应)为如何健全我国长护险的待遇模式制度设计提供了参考价值

关键词:

老龄化, 失能人员, 医疗费用, 动态三重差分

Abstract:

This paper uses hospitalization data of disabled applicants in Chengdu, a pilot city of longterm care insurance, to examine the catering effect and health effect of cash–subsidized longterm care insurance. We find that: (1) The dynamic DID estimation results show that cash–subsidized long–term care insurance has a catering effect before application, that is, the disabled increase their possibility of receiving cash subsidies through low-cost excessive hospitalization before applying. (2) The further constructed dynamic DDD model indicates that the health effect reduces the hospitalization rate of the disabled by 5.8 percentage points, and the total monthly hospitalization cost by 52.3%. (3) Heterogeneity analysis finds that the health effect is more pronounced among disabled groups with home care providers, lower levels of disability, and lower income levels. Our results test the shortcomings and advantages of cash–subsidized long-term care insurance, providing empirical evidence for improving the design of long–term care insurance benefits in China.

Key words:

ageing, the disabled, hospitalization cost, dynamic DDD