Home or institution: A comparative analysis of elderly care efficacy in China

IF 2.9 3区经济学 Q1 ECONOMICS Journal of Asian Economics Pub Date : 2025-02-22 DOI:10.1016/j.asieco.2025.101894

Chunfeng Zhang, Xiaoyan Lei

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Abstract

Institutional care and home-based care represent two fundamental components of elderly care systems across Asian countries. This study leverages the exogenous shock induced by the Long-Term Care Insurance (LTCI) pilot program in China to comparatively assess the efficacy of institutional versus home-based care. The analysis reveals that, relative to home-based care, institutional care more effectively addresses the caregiving needs of the elderly and enhances their access to medical services. However, it also entails higher caregiving costs and may contribute to negative outcomes, such as accelerated cognitive decline, deterioration in instrumental activities of daily living (IADL), and impaired vision, although it does not appear to increase short-term mortality risk. Further investigation suggests that these adverse effects may be linked to limited social engagement and reduced daily activities within institutional settings. These results underscore the critical need for care systems to address not only the basic care and medical requirements of the elderly but also their higher-level needs to improve their overall well-being.

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来源期刊

Journal of Asian Economics ECONOMICS-

CiteScore

4.70

自引率

9.40%

发文量

期刊介绍： The Journal of Asian Economics provides a forum for publication of increasingly growing research in Asian economic studies and a unique forum for continental Asian economic studies with focus on (i) special studies in adaptive innovation paradigms in Asian economic regimes, (ii) studies relative to unique dimensions of Asian economic development paradigm, as they are investigated by researchers, (iii) comparative studies of development paradigms in other developing continents, Latin America and Africa, (iv) the emerging new pattern of comparative advantages between Asian countries and the United States and North America.