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Using national representative data from four waves of CHARLS (2011, 2013, 2015, 2018), we find that LTCI decreases older adults\u2019 monthly outpatient visits but is associated with an increase in both annual inpatient stays and inpatient medical expenses. Further evidence suggests that older adults covered by the pilot LTCI program have better health status compared to their counterparts in non-pilot cities. Overall, findings offer empirical support for the role of the LTCI program in Chinese older adults\u2019 hospital service utilization, medical expenses, and health. Findings of China\u2019s LTCI may offer insights for other countries with a large aging population but with no feasible LTCI framework.<\/jats:p>","DOI":"10.1177\/07334648261488576","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:08:29Z","timestamp":1791472109000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Does the Pilot Long-Term Care Insurance Work as Expected in China? 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