Optimization Scheme Design of Long-term Care Insurance Financing in China : A System Dynamics Simulation

Corresponding author: FANG Ya, fangya@xmu.edu.cn

DOI: 10.12201/bmr.202211.00018

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  Abstract: Objective: This study aimed to explore the relationship between revenue and expenditure of long-term care insurance(LTCI) and its influencing factors, and to predict the changing trend of LTCI funds, so as to provide evidence for the establishment of an unified and sustainable financing mechanism of LTCI in China. Methods: The current situation and its main influencing factors of supply and demand of LTCI funds were determined by literature analysis, system analysis, questionnaire survey, and expert consultation. We constructed the model of Chinas LTCI financing according to the system dynamics (SD) method and used it for simulation. Results: Based on the principle of fund sustainability, this study produces 45 financing combination schemes. According to the judgment standard that the funds balance presents a relatively gentle curve, no less than the horizontal axis, and the maximum value (inflection point) should appear in the later period of forecast, combined with the policy suggestions that the payment level of LTCI is greater than 80%, five better financing schemes are finally screened. These five financing schemes have no deficit and excessive balance in the forecast period, which is in line with the principle of sustainability. It can provide reference for the selection of financing schemes in pilot areas. Conclusions: By appropriately increasing the individual payment rate, strengthening the disability intervention of the elderly, formulating scientific and objective disability evaluation standards, and finally establishing a dynamic financing adjustment mechanism of LTCI. This study can provide a basis for the scientific formulation of LTCI financing mechanism in China, and provide a reference for developing countries to establish a sustainable LTCI.

  Key words: long-term care insurance; financing mechanism; system dynamics model; simulation and optimization

  Submit time: 23 November 2022

  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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