Effect Evaluation of the Long-Term Care Insurance (LTCI) System on the Health Care of the Elderly: A Review

Linhong Chen; Xiaocang Xu

doi:10.2147/JMDH.S270454

Effect Evaluation of the Long-Term Care Insurance (LTCI) System on the Health Care of the Elderly: A Review

J Multidiscip Healthc. 2020 Aug 25:13:863-875. doi: 10.2147/JMDH.S270454. eCollection 2020.

Authors

Linhong Chen^{1

2}, Xiaocang Xu^{3

4}

Affiliations

¹ School of Mathematics and Statistics, Chongqing Technology and Business University, Chongqing 400067, People's Republic of China.
² School of Public Administration, Sichuan University, Chengdu 610065, People's Republic of China.
³ School of Economics, Chongqing Technology and Business University, Chongqing 400067, People's Republic of China.
⁴ Department of Actuarial Studies & Business Analytics, Macquarie University, Sydney 2109, Australia.

Abstract

Background: How to cope with the rapid growth of LTC (long-term care) needs for the old people without activities of daily living (ADL), which is also a serious hazard caused by public health emergencies such as COVID-2019 and SARS (2003), has become an urgent task in China, Germany, Japan, and other aging countries. As a response, the LTCI (long-term care insurance) system has been executed among European countries and piloted in 15 cities of China in 2016. Subsequently, the influence and dilemma of LTCI system have become a hot academic topic in the past 20 years.

Methods: The review was carried out to reveal the effects of the LTCI system on different economic entities by reviewing relevant literature published from January 2008 to September 2019. The quality of 25 quantitative and 24 qualitative articles was evaluated using the JBI and CASP critical evaluation checklist, respectively.

Results: The review systematically examines the effects of the LTCI system on different microeconomic entities such as caretakers or their families and macroeconomic entities such as government spending. The results show that the LTCI system has a great impact on social welfare. For example, LTCI has a positive effect on the health and life quality of the disabled elderly. However, the role of LTCI in alleviating the financial burden on families with the disabled elderly may be limited.

Conclusion: Implementation of LTCI system not only in reducing the physical and mental health problems of health care recipients and providers, and the economic burden of their families, but also promote the development of health care service industry and further improvement of the health care system. However, the dilemma and sustainable development of the LTCI system is the government needs to focus on in the future due to the sustainability of its funding sources.

Keywords: LTC; LTCI; aging society; dilemma; effectiveness; fund-raising; long-term care; long-term care insurance.

Publication types

Review

Grants and funding

This research was funded by China Chongqing Education Commission Humanities and Social Sciences Research Project “Study on the pilot evaluation and optimization path of Long-term care insurance payment policy”, grant number No: 20SKGH106, the MOE Project of Key Research Institute of Humanities and Social Sciences of Research Center for Economy of Upper Reaches of the Yangtse River, grant number No: CJSYTD201710, and Chongqing Technology and Business University “Responding to Major Public health Emergencies” thematic research project “Study on the deepening Path of Chongqing’s long-term Care Insurance System in the Post-COVID-2019 Era”, grant number No: ctbuyqzx10.