通讯作者: 马琦峰, ruc_maslow@163.com

DOI：10.12201/bmr.202608.00034

Health Spillover Effects of Long-Term Care Insurance: Empirical Evidence from Younger-Old Caregivers

• 摘要：目的：在“老老照护”日益普遍的背景下,聚焦60—74岁低龄老年照护者,评估长期护理保险(长护险)是否会对原定政策目标以外的低龄老年照护者产生健康溢出效应,并识别其作用机制和异质性表现。方法：基于2014—2023年中国老年社会追踪调查的5期数据,构建三重差分模型,识别长护险对低龄老年照护者多维健康的影响。结果：长护险对低龄老年照护者多维健康具有显著正向溢出效应,这集中体现为抑郁水平降低和社会适应提升；这种效应主要通过缓解照护压力、促进社交娱乐2条路径发挥作用；社会经济地位较低,以及处于经济、医疗相对欠发达地区的低龄老年照护者获益更大。结论：长护险能够通过溢出效应改善低龄老年照护者健康状况,并在一定程度上发挥促进健康公平的政策功能。未来应在完善正式照护供给的同时,将家庭照护者纳入支持框架,强化喘息服务和健康促进安排,并加大对弱势群体和欠发达地区的倾斜投入,以提升制度公平性和普惠性。

  关键词： 长期护理保险; 溢出效应; 多维健康; 老年人; 低龄老年照护者

   

  Abstract: Objective: As population ageing accelerates, caregiving by older family members has become increasingly common. This study focuses on younger-old caregivers aged 60–74 and assesses whether long-term care insurance (LTCI) generates health spillover effects for this group beyond its intended beneficiaries. We further examine the mechanisms and heterogeneity of these effects. Methods: Using five waves of panel data from the China Longitudinal Aging Social Survey (CLASS) covering 2014–2023, we apply a Difference-in-Difference-in-Difference (DDD) design to estimate the impact of LTCI on multidimensional health outcomes among younger-old caregivers. Results: LTCI is associated with significant positive spillover effects on younger-old caregivers’ multidimensional health, primarily reflected in fewer depressive symptoms and better social adaptation. These effects operate mainly through two pathways, reduced caregiving-related stress and increased social and leisure engagement. The benefits are larger for younger-old caregivers with lower socioeconomic status and for those living in economically and medically less developed areas. Conclusions: LTCI can improve the health of younger-old caregivers through spillover effects and may contribute to health equity. Future reforms should strengthen formal care provision while explicitly incorporating family caregivers into the policy support framework. This includes expanding respite services and health-promotion provisions, and prioritizing support for disadvantaged groups and less developed areas to improve equity and access.

  Key words: Long-Term Care Insurance; Spillover Effect; Multidimensional Health; Older Adults; Younger-Old Caregivers

  提交时间：2026-08-17

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-03-02	10.12201/bmr.202608.00034V1	下载

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