Assessing the Alignment of Long-Term Care Insurance Benefits and Service Provision: Evidence from Shandong, China and...

Area of Science:

• Health Services Research
• Public Policy Analysis
• Gerontology

Background:

• Long-Term Care Insurance (LTCI) is crucial for supporting aging populations.
• Assessing the alignment between LTCI benefits and service availability is vital for system effectiveness.
• China's rapidly aging demographic necessitates robust LTCI policy evaluation.

Purpose of the Study:

• To evaluate the alignment between Long-Term Care Insurance benefit levels and long-term care service supply in Shandong Province.
• To identify intercity disparities and mismatches in LTCI benefit design and service delivery.
• To pinpoint key barriers hindering the coordination between LTCI benefits and service provision.

Main Methods:

• Utilized field investigations and administrative data (2023-2024) for 16 prefecture-level cities.
• Developed composite indicators for LTCI benefits (breadth, depth, sustainability) and service supply (capacity, human resources).
• Applied Entropy Weighted TOPSIS and Coupling Coordination Degree Model (CCDM) to assess alignment and identify obstacles.

Main Results:

• Significant intercity disparities observed in both LTCI benefit levels (F1: 0.237-0.798) and service supply (F2: 0.049-0.695).
• Only one city achieved high coordination; most were at primary or lower stages.
• Human resource capacity (36.9% of obstacles) and insufficient payment standards were dominant barriers.

Conclusions:

• Shandong's LTCI system exhibits significant heterogeneity and structural mismatches.
• Human resources and payment standards impede the translation of insurance funds into accessible care.
• Policy recommendations include integrated coordination, dynamic payment adjustments, and human resource stabilization for sustainability and equity.