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Long-term care insurance and accessibility of home and community-based services for older adults: evidence from China

Chen Bai et al.

Health Economics, Policy and Law2026https://doi.org/10.1017/s1744133125100303article
ABDC B
Weight
0.50

Abstract

With population aging, the establishment of universal long-term care insurance (LTCI) has emerged as a critical policy issue. This paper examines the effects of China's LTCI pilots on the physical accessibility of home and community-based services (HCBS) and specific services for older adults. Using three-wave panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we analyze the rollout of LTCI pilots across different cities from 2014 to 2021, employing a time-varying difference-in-differences (DID) approach. Our findings indicate that LTCI significantly improves access to HCBS for older adults, particularly in personal daily care. Heterogeneity analysis indicates that LTCI has a stronger positive effect on the accessibility of HCBS for older adults with physical impairment, lower financial transfers from children, or living alone or with a spouse only, and the positive effect is more salient in regions with higher reimbursement for HCBS and more generous coverage. This study provides compelling evidence regarding the pivotal role of institutional design of LTCI in shaping older adults' care-seeking behavior and system-level resource allocation. It offers nuanced insights into the evaluation of differentiated pilot programs across cities, which can inform the development of a uniform national LTCI policy and carry implications for other developing countries.

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https://doi.org/https://doi.org/10.1017/s1744133125100303

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@article{chen2026,
  title        = {{Long-term care insurance and accessibility of home and community-based services for older adults: evidence from China}},
  author       = {Chen Bai et al.},
  journal      = {Health Economics, Policy and Law},
  year         = {2026},
  doi          = {https://doi.org/https://doi.org/10.1017/s1744133125100303},
}

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Evidence weight

0.50

Balanced mode · F 0.40 / M 0.15 / V 0.05 / R 0.40

F · citation impact0.50 × 0.4 = 0.20
M · momentum0.50 × 0.15 = 0.07
V · venue signal0.50 × 0.05 = 0.03
R · text relevance †0.50 × 0.4 = 0.20

† Text relevance is estimated at 0.50 on the detail page — for your query’s actual relevance score, open this paper from a search result.