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<p>This study analyzes nationwide micro-survey data from the Chinese Longitudinal Healthy Longevity Survey 2018 to assess the impact of home care and medical insurance on the health of older people in China, using factors that influence healthcare utilization. Applying the Andersen model, the findings reveal: (1) Home care and medical service use are complementary, increasing inpatient service utilization and total medical costs. (2) The effect varies by insurance type. Under the New Rural Cooperative Medical Scheme, home care raises inpatient service use and costs. Under Urban Employee/Resident Medical Insurance, home care has no statistically significant impact. Under Public Medical Care for Civil Servants, home care reduces inpatient service use, suggesting substitution. (3) Age-related patterns differ across programs, with the New Rural Cooperative Medical Scheme showing declining utilization, the Urban Employee/Resident Medical Insurance exhibiting a diminishing increase, and the Public Medical Care for Civil Servants indicating potential overuse. The Chinese government should consider restructuring its national medical insurance programs and promoting the substitutive effect of home care to enhance the well-being and social security of the aging population.</p>

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Effects of Home Care on the Use of Medical Services by the Elderly in China’s National Medical Insurance System

  • 期刊论文

  • 发表日期：

    2025年11月25日

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  • Wenshuai Qin,
  • Chien-ping Chen,
  • Yangyang Wang,
  • Hong Chen,
  • Ze Zhang,
  • Lijian Qin

摘要

This study analyzes nationwide micro-survey data from the Chinese Longitudinal Healthy Longevity Survey 2018 to assess the impact of home care and medical insurance on the health of older people in China, using factors that influence healthcare utilization. Applying the Andersen model, the findings reveal: (1) Home care and medical service use are complementary, increasing inpatient service utilization and total medical costs. (2) The effect varies by insurance type. Under the New Rural Cooperative Medical Scheme, home care raises inpatient service use and costs. Under Urban Employee/Resident Medical Insurance, home care has no statistically significant impact. Under Public Medical Care for Civil Servants, home care reduces inpatient service use, suggesting substitution. (3) Age-related patterns differ across programs, with the New Rural Cooperative Medical Scheme showing declining utilization, the Urban Employee/Resident Medical Insurance exhibiting a diminishing increase, and the Public Medical Care for Civil Servants indicating potential overuse. The Chinese government should consider restructuring its national medical insurance programs and promoting the substitutive effect of home care to enhance the well-being and social security of the aging population.