Does Long-Term Care Insurance Reduce the Burden of Informal Family Caregiving? Evidence from China’s Pilot Program
DOI:
https://doi.org/10.63808/ghc.v2i1.495Keywords:
Long-term care insurance, Informal family caregiving, Care burden, CHARLS, China, Staggered difference-in-differencesAbstract
China’s rapid population aging has intensified demand for long-term care and shifted much of the practical burden of daily care onto family members. This study examines whether China’s long-term care insurance (LTCI) pilot program reduces informal family caregiving burden. Using data from the China Health and Retirement Longitudinal Study (CHARLS) for 2011, 2013, 2015 and 2018, supplemented by a secondary binary-outcome extension using the 2020 wave, the study links individual survey records with city-level LTCI implementation timing and estimates individual fixed-effects difference-in-differences models with city-clustered standard errors. The analysis distinguishes care participation from care intensity by examining any family care, monthly family-care hours, spouse care, child/grandchild care and high-intensity caregiving. The estimates show that family caregivers remain central after policy exposure, with the coefficient on any family care close to zero (0.023, p=0.357). The monthly-hours estimate is negative (-106.4 hours, p=0.366), and the formal-care coefficient is small (0.005, p=0.567). This pattern suggests that China’s early LTCI pilots function more as a partial support mechanism for families than as a direct substitute for informal care. The findings highlight the importance of combining insurance coverage with stronger home- and community-based service supply, especially for older adults with severe care needs and households with limited family resources.
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