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. 2021:1:e2021014.
doi: 10.52872/001c.29559. Epub 2021 Nov 16.

The impact of long-term care insurance in China on beneficiaries and caregivers: A systematic review

Simiao Chen  1 , Linye Li  2 , Juntao Yang  3 , Lirui Jiao  4 , Todd Golden  5 , Zhuoran Wang  6 , Haitao Liu  6 , Peixin Wu  6 , Till Bärnighausen  7 , Pascal Geldsetzer  8 , Chen Wang  9
Affiliations

The impact of long-term care insurance in China on beneficiaries and caregivers: A systematic review

Simiao Chen et al. J Glob Health Econ Policy. 2021.

Abstract

Background: China's long-term care insurance (LTCI) policy has been minimally evaluated. This systematic review aimed to assess the impact of China's LTCI pilot on beneficiaries and their caregivers.

Methods: This review is based on a search of peer-reviewed studies in English (Embase, MEDLINE, Web of Science) and Chinese (China National Knowledge Infrastructure [CNKI], VIP, Wanfang) databases from January 2016 through July 2020, with all studies published in English or Chinese included. We included quantitative analyses of beneficiary-level data that assessed the impact of LTCI on beneficiaries and their caregivers, with no restriction placed on the outcomes studied.

Results: Nine studies met our inclusion criteria. One study was a randomised trial and two used quasi-experimental approaches. Four studies examined LTCI's effect on beneficiaries' quality of life, physical pain, and health service utilisation; one study reported the effect on beneficiaries' healthcare expenditures; and one study evaluated the impact on caregivers' care tasks. These studies generally found LTCI to be associated with an improvement in patients' quality of life (including decreased physical pain), a reduction in the number of outpatient visits and hospitalisations, decreased patient-level health expenditures (e.g. one study reported a reduction in the length of stay, inpatient expenditures, and health insurance expenditures in tertiary hospitals by 41.0%, 17.7%, and 11.4%, respectively), and reduced informal care tasks for caregivers. In addition, four out of four studies that evaluated this outcome found that beneficiaries' overall satisfaction with LTCI was high.

Conclusion: The current evidence base for the effects of LTCI in China on beneficiaries and their caregivers is sparse. Nonetheless, the existing studies suggest that LTCI has positive effects on beneficiaries and their caregivers. Further rigorous research on the impacts of LTCI in China is needed to inform the future expansion of the program.

Keywords: China; beneficiaries and caregivers; long-term care insurance; systematic review.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES The authors completed the ICMJE Unified Competing Interest form at (available upon request from the corresponding author), and declare no conflicts of interest.

Figures

Figure 1.
Figure 1.. Systematic review study selection flow diagram
CNKI=China National Knowledge Infrastructure
See this image and copyright information in PMC

References

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