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

Corresponding author: Ma Qifeng, ruc_maslow@163.com

DOI: 10.12201/bmr.202608.00034

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  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

  Submit time: 17 August 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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  1	2026-03-02	10.12201/bmr.202608.00034V1	Download

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