{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:55:05Z","timestamp":1793796905424,"version":"4.6.1"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["HEPL"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>With population aging, the establishment of universal long-term care insurance (LTCI) has emerged as a critical policy issue. This paper examines the effects of China\u2019s LTCI pilots on the physical accessibility of home and community-based services (HCBS) and specific services for older adults. Using three-wave panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we analyze the rollout of LTCI pilots across different cities from 2014 to 2021, employing a time-varying difference-in-differences (DID) approach. Our findings indicate that LTCI significantly improves access to HCBS for older adults, particularly in personal daily care. Heterogeneity analysis indicates that LTCI has a stronger positive effect on the accessibility of HCBS for older adults with physical impairment, lower financial transfers from children, or living alone or with a spouse only, and the positive effect is more salient in regions with higher reimbursement for HCBS and more generous coverage. This study provides compelling evidence regarding the pivotal role of institutional design of LTCI in shaping older adults\u2019 care-seeking behavior and system-level resource allocation. It offers nuanced insights into the evaluation of differentiated pilot programs across cities, which can inform the development of a uniform national LTCI policy and carry implications for other developing countries.<\/jats:p>","DOI":"10.1017\/s1744133125100303","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:54:53Z","timestamp":1768208093000},"page":"1-16","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Long-term care insurance and accessibility of home and community-based services for older adults: evidence from China"],"prefix":"10.1017","author":[{"given":"Chen","family":"Bai","sequence":"first","affiliation":[{"name":"Renmin University of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2315-5947","authenticated-orcid":false,"given":"Zhenyu","family":"Zhu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00p991c53","id-type":"ROR","asserted-by":"publisher"}],"name":"Huazhong University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Renmin University of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4942-4184","authenticated-orcid":false,"given":"Mengting","family":"Li","sequence":"additional","affiliation":[{"name":"Renmin University of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"S1744133125100303_ref18","doi-asserted-by":"publisher","DOI":"10.1596\/978-1-4648-1075-6"},{"key":"S1744133125100303_ref30","unstructured":"Ministry of Civil Affairs of China. Statistical bulletin on the development of civil affairs in 2023. Available from https:\/\/www.mca.gov.cn\/n156\/n2679\/c1662004999980001204\/attr\/355717.pdf. 2024."},{"key":"S1744133125100303_ref33","volume-title":"Handbook of Aging and the Social Sciences","author":"Perkins","year":"2021"},{"key":"S1744133125100303_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2020.112812"},{"key":"S1744133125100303_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32136-X"},{"key":"S1744133125100303_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/BF02353995"},{"key":"S1744133125100303_ref39","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbae168"},{"key":"S1744133125100303_ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2017.08.025"},{"key":"S1744133125100303_ref42","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czaf027"},{"key":"S1744133125100303_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2015.10.008"},{"key":"S1744133125100303_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2017.09.011"},{"key":"S1744133125100303_ref21","doi-asserted-by":"publisher","DOI":"10.2307\/1912352"},{"key":"S1744133125100303_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbae023"},{"key":"S1744133125100303_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2005.07.018"},{"key":"S1744133125100303_ref7","doi-asserted-by":"publisher","DOI":"10.2307\/2976491"},{"key":"S1744133125100303_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/45.2.177"},{"key":"S1744133125100303_ref17","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2013.782060"},{"key":"S1744133125100303_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.115563"},{"key":"S1744133125100303_ref23","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1963.03060120024016"},{"key":"S1744133125100303_ref8","unstructured":"Dang, J (2023) China report of the development on ageing industry (2021-2022)."},{"key":"S1744133125100303_ref31","unstructured":"National Healthcare Security Administration. (2024) Statistical Bulletin on the Development of National Healthcare Security in 2023. Available from https:\/\/www.gov.cn\/lianbo\/bumen\/202407\/content_6964551.htm."},{"key":"S1744133125100303_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s11113-023-09810-1"},{"key":"S1744133125100303_ref13","volume-title":"Embracing challenges for population aging in China: Building scientific evidence to inform long-term care policymaking and practice","author":"Feng","year":"2023"},{"key":"S1744133125100303_ref38","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4020-6752-5"},{"key":"S1744133125100303_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2023.102781"},{"key":"S1744133125100303_ref9","doi-asserted-by":"publisher","DOI":"10.1257\/aer.20181169"},{"key":"S1744133125100303_ref40","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19031656"},{"key":"S1744133125100303_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeconom.2021.03.014"},{"key":"S1744133125100303_ref37","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbae039"},{"key":"S1744133125100303_ref36","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4634"},{"key":"S1744133125100303_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2012.12.011"},{"key":"S1744133125100303_ref28","first-page":"90","article-title":"Public long-term care insurance and consumption of elderly households: EVIDENCE from China","author":"Liu","year":"2023","journal-title":"Journal of Health Economics"},{"key":"S1744133125100303_ref14","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.21.2602"},{"key":"S1744133125100303_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czac003"},{"key":"S1744133125100303_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2020.113081"},{"key":"S1744133125100303_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpubeco.2014.12.004"},{"key":"S1744133125100303_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2020.102354"},{"key":"S1744133125100303_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.114745"},{"key":"S1744133125100303_ref29","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-021-02069-1"},{"key":"S1744133125100303_ref20","article-title":"Long-term care providers and services users in the United States, 2015-2016: national center for health statistics","volume":"3","author":"Harris-Kojetin","year":"2019","journal-title":"Vital Health Statistics"},{"key":"S1744133125100303_ref3","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.19.3.26"},{"key":"S1744133125100303_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.14080"}],"container-title":["Health Economics, Policy and Law"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1744133125100303","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:54:58Z","timestamp":1768208098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1744133125100303\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":42,"alternative-id":["S1744133125100303"],"URL":"https:\/\/doi.org\/10.1017\/s1744133125100303","relation":{},"ISSN":["1744-1331","1744-134X"],"issn-type":[{"value":"1744-1331","type":"print"},{"value":"1744-134X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}