《保险研究》20211202-《长期护理保险会挤出家庭照护吗？——基于2011～2018年CHARLS数据的实证分析》（朱铭来、何敏）

［摘   要］随着人口老龄化,失能老人照护问题日益凸显,探索建立长期护理保险制度是保障失能老人基本生活权益、实现改革发展成果共享的重要战略举措。本文基于2011～2018年CHARLS数据,以长期护理保险制度试点作为准自然实验,运用双重差分法、三重差分法以及一系列稳健性检验方法,研究长期护理保险对老年人口家庭照护的影响效应。研究发现,长期护理保险挤出家庭照护。异质性分析表明,长期护理保险的挤出效应因失能等级与照护者类型不同而有所差异,表现为对处于重度失能、接受来自子女及孙辈提供照护服务的老年人口而言,长期护理保险对其家庭照护的挤出效应更明显。作用机制检验表明,“向下”代际经济分担是长期护理保险影响家庭照护的重要传导渠道。

［关键词］长期护理保险；家庭照护；失能老人

［基金项目］天津市哲学社会科学规划项目“贫困老人和儿童的公平健康保障体系建设研究——以天津市为例”(TJLJ18-002)。

［作者简介］朱铭来,南开大学金融学院、周恩来政府管理学院教授,研究方向:卫生经济与医疗保障；何  敏(通讯作者),南开大学金融学院博士研究生,研究方向:卫生经济与医疗保障。

Does Long-Term Care Insurance Crowd out Informal Care?—Evidences from 2011-2018 CHARLS Data

ZHU Ming-lai,HE Min

Abstract：As the development of aging population,the problem of caring for the disabled elderly is becoming increasingly prominent,which means establishing a long-term care insurance system is an important strategic measure to protect the basic living of the disabled elderly and share the fruits of reform and development in China. This paper used DID and DDD model to estimate the impacts of long-term care insurance on informal care for the elderly by utilizing data of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 and regarding long-term care insurance as a quasi-natural experiment. The results show that long-term care insurance crowds out informal care. Further heterogeneous analysis results show that the crowding-out effect of long-term care insurance on informal care differs with different disability levels and types of care-takers. Namely,it is more obvious for the elderly with severe disability and receiving informal care from children and grandchildren. The mechanism test results show that "downward" intergenerational financial sharing is an important transmission channel for the effect of long-term care insurance on informal care.

Key words：long-term care insurance;informal care;the disabled elderly