With the change of demographic structure, China began to actively explore the establishment of a long-term care insurance system, especially the financing method. The paper learns the well-developed German mode of long-term care insurance financing legal system, explores the localization project based on the national condition and pilot experience, and suggests that we should establish a national planning in the form of law, achieve independent and diversified financing and a coordinated fund system to satisfy the demand for care and the balance of payment.

Objective: The paper explores the degree of demand for community care services in urban and rural areas and the contributing factors. Methods: Based on the survey data of CLHLS for the elderly aged 65 and above from 2017 to 2018, this study establishes the index system by Anderson behavior model and analyzes the differences across the country and between urban and rural areas by logistic binary regression model. Results: There is strong demand for community care both in the urban and rural areas and the rural areas proves to be more demanding. As to the similarities of contributing factors in urban and rural areas, loneliness has a strong impact on the demand for community care services for the elderly, which also reflects the prominent advantages of community care over other forms of care. The influence of nature of employment and income differs significantly. Conclusion: Community care services should pay attention to the functional construction of spiritual comfort, and carry out differentiated design according to the different demand characteristics of urban and rural areas. We should promote the distribution of care resources to rural communities to strengthen rural care resources.

As one of the most common chronic diseases, diabetes brings heavy burden to the whole society. However, the healthcare security of diabetes outpatient still need to be improved, and the incentives for diabetes management are limited, which is not conducive to guarantee the health of patients. Diabetes care mode in Taiwan Province has been developed for a long time, which can effectively motivate medical staffs to promote diabetes management. This article systematically elaborates the implementation details of the mode, including qualification certification of medical providers, patient enrollment and management, indicators of pay for performance, etc., in order to provide suggestions for the improvement of diabetes management in China's mainland.

The higher income of urban and rural residents in Zhejiang Province and the relatively balanced healthcare service system for seniors has laid a sound foundation for the comprehensive promotion of the long-term care insurance pilot. Also the five-year pilot accumulated rich experience as an “important window”. Therefore, during the 14th Five-Year Plan period, joint efforts should be made in terms of institutional positioning, resource integration, financial support, staff professionalization, PPP cooperation, and the combination of medical treatment and care.

In order to clarify the policy attributes of China's long-term care insurance pilot scheme, the research method of text analysis was adopted, and policy tools were used to identify the policy attributes of the long-term care insurance pilot scheme. The research indicates that the policy attributes of the 28 long-term care insurance pilot schemes are mainly de-familyization, the policy tools used in the pilots are relatively simple and during the implementation the pilots lack policy support for family caregivers. According to foreign experience and the actual needs of China, the dual attributes of familialization and de-familialization should become the ideal positioning of China's long-term care insurance system in the future. Therefore, long-term care insurance system should provide various forms of payment combination for the disabled elderly and strengthen policy support for family caregivers.

Objective: The paper is to analyze the progress of research on long-term care insurance pilots in China. Methods: 126 papers with the topic of "long-term insurance pilot" published from 2016 to 2021 were derived from the CNKI database. By using CiteSpace software, the knowledge map and time series map of key words were drawn to conduct visualized analysis on research content and focus. Results: The number of literature on long-term care insurance pilot has increased steadily, but there is little cooperation between authors. The contents of research could be classified into five groups, including the necessity and feasibility of long-term care insurance system, insurance benefit, care service, financing mechanism, pilot effect and related issues. The changes of research focus could be divided into three stages, including slow exploration period (2016), fast growth period (2017-2019) and steady growth period (2020-present). The design of long-term insurance system, financing method and the evaluation on the pilot effect are the research focus at present. Conclusion: The research on long-term care insurance pilot showed a periodic trend and were becoming more complicated. The further study should adopt innovative methodologies to strengthen the systematic research at national level.

Population aging is an important social issue concerned by the government. This paper studies the current situation during the implementation of long-term care insurance from the three aspects of opportunity equity, process equity and outcome equity, analyzes the problems such as limited coverage, unfair resource allocation and proposes to expand coverage and optimize the allocation of nursing facility, in order to benefit the further development of long-term care insurance system.

South Korea's long-term care insurance has integrated experience of Germany and Japan, and carried out pilot projects in terms of management and operation system, social welfare level and financial expenditure. It has developed into an inclusive and generous system which is friendly to low-income groups. This development model has important implications for the pilot program of China's long-term care insurance system.

As one of the first batch of pilot cities of long-term care insurance system, Guangzhou has gone through the initiation, development and deepening stages of exploration since 2017. Based on local conditions and guided by the practical service needs of disabled people, Guangzhou has entrusted commercial insurance companies to undertake part of long-term care insurance business, and has given consideration to the development of institutional care and home care. It has actively explored the Internet plus, continuing care and informal care, and opened up the way of long-term care insurance practice with Guangzhou characteristics. In the future, it is necessary to further optimize the payment mode of long-term care insurance, gradually establish the service catalog of long-term care insurance, improve the long-term care insurance evaluation system.

Objective: The paper attempts to provide a theoretical, practical research basis for actively coping with aging, realize the sustainable development of long-term care insurance system in terms of service supply by understanding the demand of elderly people for long-term care services in a city. Methods: 40Designated Nursing Institutions in a city were randomly selected to send questionnaires to the elderly aged60years, above. The Kano model was used to classify the demand attributes of the elderly, a two-dimensional matrix diagram of the demand was made according to the Better-Worse coefficient. Results: The overall demand attribute classification of long-term care services for the elderly showed that24services were divided into One-dimensional, Indifferent, 13services were Indifferent, 11services were One-dimensional. There were differences in the division of Attractive, Must-be, One-dimensional, Indifferent among the elderly with different health conditions. Conclusions: The general cognition of the needs of the elderly aged60years, above in designated nursing institutions in the city is still insufficient. The physiological needs of disabled people can be basically met, but there is still a big gap in safety needs, social needs. It is suggested to enrich long-term care service items, develop nursing service standards, implement targeted long-term care services according to health status

This paper systematically analyzes the content of LTCI policies of cities in Shandong Province from the dimensions of guaranteed population, fund raising, evaluation criteria, benefit payment. At the same time, this article discusses the main achievements in the implementation of the policy, the aspects that should be improved in the next step. Then, we put forward the corresponding countermeasures, suggestions for improving the LTCI system in Shandong Province, China

China's long-term care insurance has experienced more than 10 years, from spontaneous exploration to national pilots, and has accumulated some practical experience and theoretical achievements. However, the academic studies on the supply side, especially research on the socialized platform services of important supply side carriers, are relatively not enough. This paper takes the innovation of long-term care insurance management service and the improvement of supply side capacity as the starting point, analyzes the background and necessity of socialized long-term care insurance service platform in China, and puts forward suggestions and preliminary ideas for building a socialized service platform for long-term care insurance, so as to provide reference for decision-making and research.

In order to actively cope with the risk of large-scale disability caused by the rapid development of population aging, China urgently needs to establish a sound long-term care service system. The United States entered the aging society earlier, long-term care services developed earlier with more mature experience. Studying the successful experience of the long-term care services development in the United States has important implications for improving China's long-term care service system. This article introduces the development background, content overview, experience of long-term care services in the United States, puts forward countermeasures, suggestions to improve the development of long-term care services in China

Objective: The paper attempts to explore the disease characteristics of Jinjiang long-term care insurance applicant, provide reference for the applicants’ nursing service, health management. Methods: We collect, select the people who applied for long-term care insurance in Jinjiang City from October1, 2020to May31, 2021as the research objects, make classification on the disease diagnosis of patients. Results: 325applicants apply for single disease, accounting for40.42% while479applicants apply for comorbid diseases, accounting for59.58%. The number of comorbid diseases ranges from2to4, there are465cases in this interval, accounting for97.1% of the total number of comorbid diseases. Hypertensionaccounts for the highest proportion in the top ten disease types of the insured. The prevalence rate of cerebral infarction, chronic obstructive pulmonary disease in men is significantly higher than that in women, the number of lower limb fractures in women is far higher than that in men. Conclusion: The disease burden of the applicant is directly in proportion to age, disease type, number of diseases, both men, women have a high comorbidity rate. We should take the characteristics of applicants in order to further optimize the service content of long-term care insurance

To clarify the basics, similarities and differences between the German and Japanese long-term care insurance systems, this paper adopts the classic Neil Gilbert's welfare system analysis framework to summarize and compare the beneficiary objects (who), benefit contents (what), transmission channels (how) and financing methods (how) of the two systems. This paper proposes policy recommendations for the establishment of a long-term care insurance system in China, taking into account China's national conditions.

Qianxinan Prefecture is the only state in Guizhou Province selected as the second batch of pilot cities of long-term care insurance. As an ethnic minority region, underdeveloped area and longevity township, Qianxinan prefecture has actively explored and constructed a long-term care insurance system and operation mechanism in line with local reality, and achieved remarkable phased results. Based on the comprehensive introduction of the long-term care insurance system in Qianxinan prefecture, this paper analyzes the problems, and puts forward some suggestions such as appropriately expand the scope of treatment enjoyment, optimize the treatment payment structure, carry out disability prevention and delay, expand the scope of auxiliary equipment rental and purchase catalogue, and carry out institutionalized risk prevention and control management. This study can provide reference for other underdeveloped areas to establish and optimize the long-term care insurance system.

Objective: Based on the background of the expansion and deepening of long-term care insurance pilots, the paper explores effective paths to provide long-term care services for moderately disabled individuals. Methods: This paper uses the data of China Health and Retirement Longitudinal Survey (CHARLS) in 2018 and Barthel index to evaluate the disability of the elderly. Results: (1) The moderate disability rate of elderly people aged over 60 in China is approximately 2.12% to 2.95%. According to the data from the 7th National Population Census, the number of moderate disability people aged over 60 is approximately 5.597 million to 7.788 million. (2) The moderately disabled elderly have higher scores on daily living activities such as eating, dressing, the defecation control, going to the toilet, and getting in and out of bed, and lower scores on bathing, going upstairs and downstairs, and walking on the ground. In addition, 70.5%, 69.5%, 67% and 68.1% of the moderately disabled elderly were assisted in shopping in the stores, cooking, housework and bathing, respectively. (3) According to the large caliber calculation, the chronic disease prevalence rate of the moderately disabled elderly was 29.4%, the hospitalization rate was 39%, the CES-D depression score was 15.027, and there was moderate and severe depression. Conclusions: It is suggested to gradually include the moderately disabled elderly into the scope of long-term care insurance and guide the moderately disabled to choose more affordable home care services through policies.

In the context of the increasing population aging in China, long-term care insurance is a key measure to actively deal with the nursing needs for disabled elderly people. This article is based on the China Health and Retirement Longitudinal Study (CHARLS) database and uses the propensity score matching-difference in differences (PSM-DID) method to study the impact of long-term care insurance on the health satisfaction of middle-aged and elderly people in China. Research shows that the implementation of long-term care insurance policies significantly improved the health satisfaction of 8.2% (P<0.01) of middle-aged and elderly people. After controlling covariates and fixed effects for propensity score matching, the policy implementation effect was 7.5% (P<0.01), which was still confirmed after a series of robust tests. Through the heterogeneity analysis, it was found that the policy effect has rich heterogeneity in terms of age, place of residence, and level of child care. Long-term care insurance has a significant positive impact on the health satisfaction of middle-aged and elderly people in rural areas, middle and young age groups, and those with almost no child care. The research conclusion of this article can be the reference when accelerating the expansion of long-term care insurance pilot cities in China and improving the fairness of institutional guarantee.

As a national pilot city of long-term care insurance, Panjin actively constructs a long-term care insurance system and operation mechanism which is in line with the local actual situation, and continuously improves the payment standards for long-term care insurance benefits. Based on the study of the payment policies of long-term care insurance in Panjin, this paper analyzes the problems in the payment, and offers suggestions such as gradually expanding the scope of payment, reasonably adjusting the evaluation criteria of disability, paying attention to the training of nursing professionals, and moderately increasing the contents of payment, so as to provide a reference for the establishment of long-term care insurance system in Liaoning Province.

With multisectoral cooperation, Canada provides a full range of high-quality care services for seniors, ensuring that seniors live a more dignified and meaningful life. Based on the framework of social welfare policy analysis, this paper introduces and analyzes the policy from the following dimensions, including the target groups of policy, the supply contents, the delivery system and the financing mode of long-term care for the elderly in Canada. Led by the local public sectors and supplemented by the private sectors, Canada used scientific and efficient evaluation mechanism to deliver a wide variety of long-term care services for the elderly. However, some policy choices have also brought about problems such as fragmented local policies, insufficient supervision by the private sectors, and single financing channel. Compared with the development of long-term care services for the elderly in Canada, this article proposes to gradually improve the evaluation mechanism, enrich service contents, promote multisectoral collaboration, and enhance financial sustainability based on the actual situation, in order to promote the high-quality development of long-term care services for the elderly in China.

Objective: The paper analyzes the development history and the operation mechanism of long-term care insurance system in Israel, and explores the problems and development path of long-term care insurance system in China. Methods: This paper analyzes the current situation of long-term care insurance system in Israel from the aspects of system design, fund raising, disability rating and payment content. Results: It is found that long-term care insurance in Israel has the following advantages: the top-level design of long-term care insurance is relatively perfect, the disability level assessment is refined, the level of nursing services is linked with income, the payment contents are various to meet diverse needs, nursing services are highly flexible and service providers are market-oriented. Conclusion: China's long-term care insurance system should improve top-level design, establish a long-term care system based on home and community care, enrich the contents of payment, provide flexible services, link reimbursement rates with income, improve service quality evaluation standards and promote the marketization of nursing service providers.

With a rapidly aging population in China, getting old before getting rich, miniaturization of family structure, weakening of traditional family care functions, and insufficient supply of elderly care services poses great challenges for us to cope with the aging population. Report to the 20th National Congress of the Communist Party of China clearly proposed the establishment of a long-term care insurance system. Based on analysis of the current aging situation and summary of the early pilots of long-term care insurance, this article proposes to establish a long-term care insurance system that covers the entire population.

Based on CHARLS data in 2011, 2013, 2015 and 2018, this article explores the impact of long-term care insurance on medical expenses and sustainability of the basic medical insurance fund with cost-benefit analysis methods. This article finds that long-term care insurance reduces total medical expenses through mechanisms such as reducing the number of individual annual outpatient visits. Since some of the long-term care insurance financing comes from the basic medical insurance fund, this article defines the amount of long-term care insurance financing from the medical insurance fund as cost, and defines the amount of medical insurance fund that long-term care insurance saves by reducing medical expenses as benefit. The paper explored the impact of long-term care insurance on the sustainability of medical insurance funds, which is the difference between the cost and benefit. The study found that based on the population prediction of the medium plan, the "90+10" plan as the care model, all disabled elderly people as the target of guarantee, and 70% as the reimbursement ratio, long-term care insurance can save 65.44 yuan to 105.05 yuan per capita for the basic medical insurance fund. At the same time, this article conducts sensitivity analysis from the perspectives of population forecast plan, nursing model and reimbursement ratio, and finds that with a specific reimbursement ratio of the long-term care insurance system, the higher the proportion of elderly people who mainly chooses home care, the long-term care insurance system can have a more positive impact on the medical insurance fund. Previous studies mainly discussed the negative effects of the long-term care insurance system on the basic medical insurance system, lacking analysis of the positive effects of the long-term care insurance system on the basic medical insurance system. This article conducts research to provide theoretical basis for national and local governments to improve the long-term care insurance system and explore the mutual feedback mechanism between long-term care insurance and basic medical insurance.

Since 2004, the proportion of people over 60 years old in Shanghai has been increasing. In the context, Shanghai has taken the lead in piloting a long-term care insurance system. With the in-depth promotion of pilots, the stability and sustainability of the nursing staff have become the key constraints on the effectiveness of long-term care insurance. Therefore, this paper conducted a questionnaire survey on the salary status of 5805 nurses from 50 institutions in 16 districts of Shanghai to summarize the demographic characteristics, social security and salary of the Shanghai nursing staff, and ordered logit regression was used to analyze the factors affecting the salary of nurses. Finally, this paper puts forward some suggestions such as building a team of high-quality nursing staff with good education background, improving the social security of nursing staff and lowering the requirements for certificates.

Objective: The paper attempts to provide a experience for the establishment and development of China's long-term care insurance system. Methods: Based on policy documents from the US federal and local health departments, combined with academic research and industry analysis, the paper traced the development process of the long-term care security system in the United States and analyzed the financing sources and benefits covered in the system. Results: In the United States, there was a clear division of labor among the various systems in terms of the people and benefit content. At the same time, in order to control the long-term care expenditure, institutional care services was gradually substituted by HCBS. However, there are also issues such as high funding pressure, difficulties in the development of commercial insurance, and the need to balance institutional and non-institutional care for benefits. Conclusion: It is suggested to establish a multi-pillar and multi-level long-term care service security system in China, clarify the system positioning and benefit content, and balance the provision and usage of institutional nursing services and non-institutional nursing services to improve the efficiency of the system.

With the acceleration of aging in China, the scale of disabled and semi-disabled people has expanded, and the demand for long-term care has sharply increased. The long-term care insurance system has covered 49 pilot cities in China since pilots were launched in 2016. In view of the interest game between different groups in the pilot of long-term care insurance system, an evolutionary game model of local government and long-term care insurance service institutions was constructed based on evolutionary game theory, the evolutionary process of the strategy selection of long-term care insurance service institutions and the government was studied, and the evolutionary stability strategies of both parties were analyzed. On this basis, the simulation results showed that rent-seeking behavior of long-term care insurance service institutions, government policy adjustment and punishment will affect the strategic choices of long-term care insurance service institutions and the government. Both sides should improve the constraint mechanism as soon as possible, establish a benign relationship of equality and mutual benefit. Therefore, we suggest that the government optimize policy content, enhance the regulation, improve construction of institutional system, promote active cooperation between long-term care insurance service institutions and the government, and promote the continuous improvement of the long-term care insurance system.

This article constructs a three-dimensional analysis framework of policy tools, policy objects, and service systems, and quantitatively analyzes the 6 policy texts of long-term care insurance system issued by the pilot cities in Central China by policy tool classification, coding, word frequency statistics, and interaction analysis, and explores the current situation of policy tool utilization in the long-term care insurance policies in Central China. The study finds that the long-term care insurance policies in Central China rely on environmental policy tools, with uneven utilization of different policy tools, and the policy content is to be refined. It is recommended to balance the use of various policy tools, formulate more detailed measures, enhance the use of new technologies, create a seniors-friendly social atmosphere, cultivate the long-term care insurance market, enrich the service providers with the strength of third-party commercial insurance companies, learn from the experience of other countries, and strengthen international communications.

Through the construction of the two-dimension analysis framework of "policy tools-policy objectives", policy coding and categorical statistical analysis, a total of 12 policy texts issued by the pilot cities of long-term care insurance system in western China were quantitatively analyzed and studied. It is found that the long-term care insurance policies issued in western China have insufficient use of demand-oriented and supply-oriented policy tools, over-reliance on environmental policy tools, and imbalance in the internal structure of each policy tool. Therefore, in the future policy formulation, the western region is supposed to make balanced use of various policy tools and optimize the structure of various sub-policy tools to achieve the goal of maximizing the realization of policy goals.

Establishing the long-term care insurance system is crucial to address the growing nursing demands associated with population aging. This study utilizes the China Health and Retirement Longitudinal Study (CHARLS) as a foundation for empirical research on the effects of long-term care insurance policies on the health status of middle-aged and elderly populations, employing the differences-in-differences method. The results indicated that the experimental group experienced a 7.83% enhancement in health status compared to the control group after implementing the long-term care insurance policies. After introducing a series of control variables and controlling for individual and time fixed effects, the policy effect was 6.94% (P<0.01), showing a significant health effect. Additionally, the health advantages of long-term care insurance vary significantly, with low-income households experiencing more pronounced improvements relative to their middle-income counterparts. These empirical findings have practical implications for expanding the long-term care insurance pilots and improving the benefit design.

Objective: The paper attempts to test the financing level and sharing mechanism of long-term care insurance in Nanning city through empirical analysis, and to provide the theoretical basis for the full implementation of long-term care insurance. Methods: ILO financing model was used to measure the financing level of long-term care insurance in Nanning, and Eviews software was used to test the feasibility of individual responsibility sharing. Results: It was estimated that the proportion of employees’ long-term care insurance in Nanning was 0.17%, which was similar to the current proportion of 0.15%, therefore the calculation was to some extent reasonable. The proportion of employees’ total personal social security contributions was much lower than the maximum individual affordability, indicating that long-term care insurance is affordable for employees. Conclusion: Nanning long-term care insurance system needs to improve the top-level design from the legislative level, establish multiple financing sources with shared responsibility, and reasonably determine the financing level based on the specific situation of each region.

The 20th National Congress of the Communist Party of China made clear the importance of establishing the long-term care insurance system. Due to the supply-demand imbalance and structure deficit of professional long-term caregiver, it is urgent to strengthen the top-level design of the long-term care insurance service system and establish a long-term caregiver professional certification and training system. This is helpful to meet the growing and diversified social demand for long-term care service and support the development of long-term care insurance system. Based on the establishment mechanism of current professional skill certification standards in China and the successful experience in long-term care talent training of Japan and the United States, this paper provides some proposals for establishing the professional certification and training system of long-term caregiver in China from the perspectives of collaborative innovation, classified management, and integration of industry and education.

In response to the increasing scale of long-term disabled elders, the weakening of family care, and the excessive pressure on residential care resources, Chengdu has established a long-term care insurance system centered on home care policies. After several years’ exploration, preliminary results have been achieved. However, there are still issues such as the deficit in quality of nursing services and accessibility of service content. This paper analyzes the home care policy of long-term care insurance in Chengdu, explores its problems and shortcomings, puts forward suggestions of improving the design of service projects, strengthening the protection of the rights and interests of nursing staff, setting basic nursing standards, and refining supervision and management norms to further improve the home care policy of long-term care insurance.

The pay-as-you-go system will be the main direction for the future development of long-term care insurance in China. It has the advantages of social risk sharing and intergenerational equity, but faces the potential risk of financial unsustainability. This article uses the CLASS cross-sectional data from 2014 to 2020 and the Barthel Index rating scale to measure the disability rates of the elderly population by age, gender, and level, applies the population projection software PADIS-INT to predict the size, structure and trend of China's population, and finally predicts the annual premium and the contribution burden level of long-term care insurance from 2020 to 2050 based on the principle of balanced budget. The results show that under the two different schemes of paying population aged from 16 to 60 and from 40 to 60, the annual premium is in the range of [380, 1546] yuan and [776, 3258] yuan respectively, and the contribution burden level is in the range of [1.06%, 1.26%] and [2.14%, 2.64%] respectively. It indicates that if the premium of long-term care insurance is at an appropriate level, it can provide favorable conditions for expanding the coverage and improving the participation intention.

Objective: The paper analyzes the operation efficiency and influencing factors of designated care service institutions with different supply modes, so as to provide theoretical evidence for improving the long-term care service system. Methods: Using the survey data of Qingdao City, 32 designated care service institutions were included. The three-stage DEA method was used to measure the operation efficiency of designated care service institutions with different supply modes, and the influencing factors were analyzed by Tobit model. Results: The average value of operation efficiency of 32 designated care service institutions is 0.647, of which PPP supply mode institutions and government supply mode institutions are 0.651 and 0.628 respectively. Supply mode, geographical location, timely settlement of long-term care insurance costs and combination of medical care and nursing has a significant positive impact on the operation efficiency of designated care service institutions. Conclusion: The designated care service institutions are still in the initial stage, and the PPP supply mode is more efficient than the government supply mode. It is necessary to adhere to the reform direction of the PPP supply mode of long-term care services, make advantage of the government's macro-control toolkit, and strengthen the promotion of the combination of medical care and nursing policies to improve the operation efficiency of designated care service institutions.

The establishment of long-term care insurance system is an important measure to actively deal with the problem of aging and disability in China. Based on the theory of developmental social welfare, this paper selects Nanning City as the research object, and analyzes the pilot practice of Nanning City's long-term care insurance system from five aspects, i.e. participants, policies, fund raising, benefits and designated institution management. It is found that the pilot of Nanning City's long-term care insurance system has established an efficient social security-commercial insurance cooperation mechanism, basically achieved independent raising, improved the supply of care resources and promoted the development of long-term insurance related industries. However, during the implementation process of the long-term care insurance system, there are still problems such as insufficient coverage of participants, lack of consensus among multiple subjects, and imbalance between supply and demand of the system. Therefore, in order to further promote the construction of long-term care insurance system, we should coordinate economic growth and social development, formulate medium and long-term development policies, build a multi-subject governance mode and strengthen talent investment.

With the research on pilot areas of long-term care insurance system in Hebei Province, the paper found that there was a problem of narrow coverage when promoting long-term care insurance, and expanding coverage would inevitably increase local financial burden, challenging sustainable development of long-term care insurance system. Therefore, based on the present situation of long-term care insurance in the pilot area of Hebei Province, this article analyzed the supply and demand of long-term care insurance funds in Hebei Province, detected the sensitive factors of the sustainable development, and put forward the countermeasures and suggestions, which provides a reference for expanding the coverage of long-term care insurance.

The rigid demand for long-term care security among elderly and disabled people in China is constantly increasing. However, due to the insufficient development of social long-term care insurance, the accelerated development of commercial long-term care insurance has become one of the important policy options. Therefore, the former China Banking and Insurance Regulatory Commission launched a pilot program for the conversion of liability between life insurance and long-term care insurance to further stimulate the potential of commercial long-term care insurance development. Based on the theory of multi-party cooperation under the leadership of government, the paper analyzes the potential risks in the pilot cities of conversion business, such as difficulties in unified goals, insufficient participation willingness and ability of all parties, lack of institutional guarantee and cooperation mechanism, etc. Based on the analysis, it is recommended to cultivate the concept of collaboration, strengthen the supply of talents, improve the institutional guarantee, and build diverse mechanisms, encouraging the exploration of new models for business conversion.

The ongoing expansion of China’s long-term care insurance (LTCI) system, characterized by diversified services, complex stakeholders, and extended supervision chains, has exposed the limitations of traditional manual supervision, including inefficiency, inadequate coverage, and heightened moral hazard. Intelligent technologies, represented by artificial intelligence (AI), offer a novel approach to enhancing LTCI supervision efficacy. Based on the investigation of the intelligent supervision practices in Hangzhou City, this study systematically identifies key dilemmas in areas such as information silos, fragmented processes, lack of procedural visibility, and blurred responsibility boundaries. It analyzes the practical applications and shortcomings of the smart medical insurance platform and institution-built systems in identity verification, process supervision, risk warning, and cost settlement. Building on this analysis, the paper constructs a comprehensive closed-loop intelligent supervision framework encompassing pre-event prevention, in-process monitoring, and post-event accountability. It designs a functional division and data interaction architecture between the supervisory and service ends and proposes optimization pathways involving multi-agent collaborative governance and the integration of humanistic care into technological applications. Finally, the study outlines five directions for future supervision system development: intelligent closed-loop supervision, deep platform integration, smart multi-agent collaboration, service-friendly orientation, and data-driven incentive and penalty mechanisms, in order to establish a technically feasible, responsibility-defined, operationally efficient, and ethically conscious intelligent supervision system for LTCI, providing practical insights for promoting the high-quality development of LTCI at the national level.

According to the theory of performance evaluation content and evaluation dimension, and in accordance with the principle of “hierarchical classification, quantitative refinement”, this paper uses Delphi to screen indicators, establishes the index weight through the objective weighting method (CRITIC) and the analytic hierarchy process (AHP), and constructs an evaluation index system with the security level and the subjective satisfaction of the insured as the core, in order to provide theoretical basis for monitoring and evaluating the implementation effect of long-term care insurance.

The payment of long-term care insurance plays an important role in allocating long-term care service resources rationally, maintaining the balance of long-term care insurance fund and adjusting the behaviors of both the supply and demand parties of long-term care insurance. This paper takes the long-term care insurance pilot of W City as an example, adopts the method of investigation and research, summarizes the contents of the long-term care insurance payment method in W City, analyzes the problems existing in the implementation process, and puts forward suggestions to optimize the long-term care insurance payment method.