Objective: The paper takes N City as an example to explore a stable, reasonable and sustainable financing mechanism of long-term care insurance, providing useful reference for exploring the "model of long-term care". Methods: Based on the data of China's Seventh National Population Census and the population cohort element model, the health status transition probability matrix results of people aged 60 and over were calculated to obtain the future disability population in N City. At the same time, the actuarial balance model of long-term care insurance was constructed to predict the future operation of the fund, and a variety of schemes were designed to calculate the sustainability and financial burden of the fund. Results: If the status quo is maintained, the cumulative fund balance in 2050 can reach 11.066 billion yuan. Moderately disabled individuals can be gradually included in the coverage, and a stable average level of guarantee in the initial stage is preferable. Under different schemes, the proportion of fiscal burden in general public budget expenditure is between 0.18% and 0.32%, and the burden is relatively reasonable and controllable. Suggestions: We should improve the design of benefit guarantee mechanism, improve the quality of long-term care services, and actively explore the connection between social security and commercial insurance in the field of long-term care.

As one of the first long-term care insurance (LTCI) pilot cities in China, Ningbo City has gradually shaped its operation mode and established “five systems” of fund-raising, disability assessment, service supply, benefit payment and claim management. Through field investigation and data statistics, this paper analyzes the implementation plan and effects of LTCI of Ningbo City in detail, and summarizes the problems of financing mechanism, disability assessment, nursing service and operation by third-party agencies. After evaluating the risks by analytic hierarchy process (AHP), it is found that the LTCI needs to pay attention to the long-term care demand risk, operational risk, service supply risk and moral hazard. This article proposes a specific path for the sustainable development of long-term care insurance in the future, which is to improve policy design and establish an independent dynamic financing system, strengthen the uniformity and transparency of disability assessment, expand the scope of guarantee and improve nursing benefits, improve the quality and regulatory level of nursing services, clarify the procedures and systems for third-party agencies, and incentivize active participation by the third-party agencies.

Long-term care insurance (hereinafter referred to as LTCI) is an important policy arrangement for actively addressing population aging and implementing the Healthy China strategy. Based on the framework of welfare pluralism, this study analyzes the dilemmas faced by China's LTCI policy from the perspectives of organizations, values, and relationships, and proposes a systematic optimization path. Specifically, by clarifying the roles and responsibilities of different parties, building consensus based on mutual benefit, coordinating interest relationships and improving the supervision and regulation system, multi-dimensional measures are taken to promote the formation of a collaborative governance pattern among the government, market, and social entities, and to promote the optimization and improvement of the LTCI system.

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.

The Chinese economy has entered a new stage of development, which requires expanding domestic demand and stimulating consumption potential. As the aging population increases, stimulating the consumption potential of the elderly will have a positive impact on promoting the domestic cycle. Studies have found that the saving rate of the elderly increases with age, and the main reason is to prevent health risk. Long-term care insurance can effectively alleviate health risk and affect household consumption expenditure behavior. From the perspective of health risk, the study applies the CFPS (2012-2018) data to explore the impact of long-term care insurance policies on household consumption expenditure decisions. The analysis results show that the implementation of the long-term care insurance system has reduced the savings rate of elderly households by 9.7%, while significantly increasing consumption expenditure, effectively promoting elderly household consumption, with a significant increase in health and entertainment consumption. The greater the health risk, the more significant the effect of long-term care insurance on promoting consumption in elderly households would be. In addition, long-term care insurance policy has a more significant effect on increasing the consumption in urban and high-income households.

Since 2016, the number of pilot cities (regions) for long-term care insurance have expanded to 49 and long-term care insurance made significant progress. Each pilot city (region) has introduced many institutional innovations tailored to local conditions, but there is also obvious policy fragmentation. This article focuses on four issues related to the fragmentation of the long-term care insurance system, including the target population benefiting from the policy, the supply structure of service modes, the focus of service projects, and the coverage boundaries of the two major institutional sectors. Emphasis was placed on analyzing four different approaches of mode selection, including operation mode, guarantee mode, financing mode, and administration mode, and corresponding policy recommendations were proposed one by one. According to the methodology of "crossing the river by feeling the stones and combining it with top-level design", this article proposes that the pilot should be completed as soon as possible and enter the top-level design stage to reduce sunk costs. According to the time nodes of establishing long-term care insurance in different countries, the establishment of long-term care insurance system in China fully reflects the basic principle of "do everything within our capacity", which is an important measure to promote Chinese path to modernization and achieve common prosperity. With the trend of population aging, it is recommended to carry out a "two-stage promotion" with the year of 2035 as the boundary to smoothly transit to a unified system for the whole country.

The balance of income and expenditure of long-term care insurance fund is an important condition to realize the sustainable development of the system. This paper takes Shanghai, which adopts proportional financing, and Suzhou, which adopts fixed amount financing in the Yangtze River Delta region, as the research object, and uses the GM (1,1) to forecast their fund balance in the next ten years from 2023 to 2032 under the condition that the policy remains unchanged. Through empirical analysis, this paper holds that first, the annual growth rate of fund income in Shanghai is significantly higher than that of expenditure, resulting in a balance rate of 80% to 97%, which is obviously high. Second, Suzhou has a slightly higher annual growth rate of fund income than expenditure. The fund balance rate is within a reasonable range of 28% to 35%, and the income and expenditure is closer to the balance state. The difference in the fund balance ratio between the two cities may be influenced by factors such as financing and benefit payments. This article suggests adopting a mixed financing form, establishing a multi-channel independent financing mechanism, improving the long-term care insurance benefit payment mechanism, avoiding fund waste, and providing a reference for the sustainable development of the long-term care insurance system.

Objective: The development of the long-term care insurance system is of great significance to enhance the level of social security and improve the welfare system for the elderly in Jilin Province. Methods: Based on the data related to the population and economic development of Jilin Province from 2014 to 2023, we applied the International Labour Organization (ILO) financing model combined with the GM (1,1) grey prediction model, and scientifically estimated that under the three scenarios of long-term care insurance benefit payment ratio of 65%, 70% and 75% respectively, the employees’ contribution ratio from 2024 to 2030 is 0.73%~1.03% and the urban and rural residents’ annual average payment is 232.56~465.67 yuan. Results: The financing level of long-term care insurance in Jilin Province is within a reasonable and relatively low interval compared to other cities in China that have launched pilot programs. The number of elderly long-term care needs and costs is rising year by year, and long-term care insurance is not sustainable when it is dependent on the basic medical insurance system. Conclusion: The long-term care insurance system for the elderly in Jilin Province should be rolled out as soon as possible, a relatively independent multi-channel financing mechanism should be established, and the level of financing should be scientifically measured and dynamically adjusted to continuously meet the growing demand for long-term care insurance among the elderly in Jilin Province and to ensure the high-quality and sustainable development of the long-term care insurance system.

The 20th National Congress of the Communist Party of China explicitly called for the "establishment of a long-term care insurance system". In 2016, China initiated a pilot project for the long-term care insurance system, and in 2020, the pilot project was further expanded. In the pilot cities, designated management of care institutions has been widely implemented, accompanied by the introduction of relevant management policies. This has alleviated the economic and transactional burdens on disabled individuals, especially those with severe disabilities, and their families. It has also promoted the development of industries related to elderly care. This article is based on survey data from designated care institutions in national long-term care pilot areas (2022), analyzing home-based service institutions, elderly care institutions, and medical institutions that provide long-term care insurance services in terms of operational aspects, service scale, service personnel, and service management. The results indicate that, currently, overall long-term care insurance services are predominantly provided by home-based service institutions, with the number of elderly care institutions and medical institutions providing institutional nursing services being roughly equivalent. There are differences in the development level and service capacity among the three types of institutions, and there is imbalance among regions. Standardization in terms of institution types, quantity, and management requirements needs improvement across different regions. This article puts forth recommendations for strategies in managing designated institutions, building the workforce of service personnel, and enhancing regulatory capabilities.

Objective: The paper attempts to analyze the “crowding-out” effect of long-term care insurance (LTCI) on intergenerational support from children to parents and its mechanisms. Methods: Based on four waves of panel data from the China Health and Retirement Longitudinal Study (CHARLS) from 2013 to 2020, a difference-in-differences (DID) model was employed to empirically examine the policy effects and mechanisms of LTCI on intergenerational support within families. Results: The implementation of LTCI significantly reduced both financial and caregiving support provided by children to their parents. Mechanism analysis revealed that LTCI decreased seniors' economic dependence on their families, thereby reducing the intergenerational support from their children. With the "exchange motivation", children were less inclined to offer financial assistance to parents. Heterogeneity analysis indicated that the impact of LTCI on intergenerational caregiving was more significant for female seniors, individuals with difficulties in daily activities, and those with poor mental health. Conclusion: LTCI can reduce the burden of intergenerational support and caregiving time within families, thereby releasing household labor. It is recommended to gradually expand the coverage of LTCI policies and diversify the payment items of LTCI policies to solve the problem of children supporting their parents.

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.

"Accelerating the completion of the shortcomings of rural elderly care services" is a major strategic deployment proposed by the third plenary session of the 20th Central Committee of the Communist Party of China. This article uses questionnaire surveys and case interviews, as well as the data of the fourth and fifth sampling surveys of the living conditions of elderly people in urban and rural areas in China, to analyze the problems and challenges faced by rural elderly care in China, based on the analysis of the changes in China's traditional rural elderly care system. The paper proposes to build a rural elderly care service system with township health centers as the main body. First, encourage qualified township health centers to provide long-term care services and make up for the shortcomings of rural elderly care services. Second, strengthen departmental linkage and financial subsidies to reduce the transformation cost of township health centers. Third, accelerate the coverage of long-term care insurance to all residents and improve the supply capacity of rural long-term care services. Fourth, rationally design long-term care insurance and medical insurance payment policies to improve the enthusiasm for service supply.

In recent years, through multiple pilot projects, China has accumulated some practical experience in developing long-term care insurance, but the financing is still a key and difficult issue. At the same time, China's interregional economic and social development is uneven, and various regions face different problems and difficulties in financing long-term care insurance. Therefore, this article takes Hainan Province as an example to analyze the demand scale and the financing path of regional long-term care insurance. The study found that with the continuous deepening of population aging, the number of disabled elderly aged 60 and above in Hainan Province will continue to increase, and the funding burden will continue to increase. It is estimated that by 2050, the total number of disabled people in Hainan Province will be 471300, including more than 60000 severely disabled groups. In terms of demand, if long-term care insurance covers moderately and severely disabled people, the scale of long-term care insurance demand in Hainan Province will reach 3.35 billion yuan by 2050. In terms of financing, the burden on employees, residents, enterprises, finance and other entities will continue to increase, and the growth rate will continue to expand over time.

Objective: The paper analyzes the current research status and development trend of long-term care insurance at home, so as to provide reference for the research and practice of long-term care insurance in China. Methods: Literature related to long-term care insurance research in China from 2010 to 2022 was obtained from CNKI, Wanfang and VIP databases. CiteSpace software was used to draw the scientific knowledge map, and visual analysis was performed on authors, research institutions, research hotspots and evolution trends in this field. Results: The scholars were not closely connected, there were not many research teams, and they have not formed closely connected research network. Research hotspots included research on the implementation status, the background of aging, and the service supply. Research trends included exploration of system, operation mode and care services. Conclusion: Domestic long-term care insurance research needs to further enhance cooperation and exchange, strengthen policy and system research, and improve the nursing service system, so as to promote the development of long-term care insurance system.

In the context of population aging, how to respond to the increasing needs of the elderly care due to disability and dementia needs to continuously improve and develop the long-term care insurance system. With the Singapore long-term care insurance system design and service system, this paper analyzes the background of the establishment and implementation of the system, financing, benefits, disability level assessment and the corresponding service management. Based on the practice of long-term care insurance in China, the paper provides suggestions, so as to provide a reference for the improvement and development of the long-term care insurance system in China. We should promote the standardization of long-term care insurance, explore the long-term care professional training mechanism, provide high-quality long-term care services matching supply with demand, strengthen the publicizing of long-term care insurance to resolve social risk of the aging, develop commercial insurance to participate in the cooperation mechanism, in order to provide the improvement and development of the long-term care insurance system.

Objective: This study aimed to clarify the boundaries between long-term care insurance (LTCI) and basic medical insurance (BMI) benefits policies, and explore the necessity and possibility of policy coherence between LTCI and BMI benefits in integrated medical and elderly care institutions. Methods: Relevant literature was retrieved and analyzed, and typical integrated medical and elderly care institutions were investigated to analyze the problems arising from the connection between their LTCI and BMI benefits policies, taking Jinjiang City as the object of study. Conclusionsand Suggestions: This study found that "nurse-free" ward service, through a payment model shared by the government (finance), medical insurance, and patients, offers new possibilities for compensating basic daily care services in integrated medical and elderly care institutions in practice. It is suggested that healthcare security departments could pilot providing medical nursing service packages for residents whose general outpatient reimbursement exceeds the cap under basic medical insurance for urban and rural residents, thereby alleviating the economic burden on the insured.

The increasing aging of the population has led to an increase of disability risk, as a result, the long-term care issues have become a common challenge faced by all countries. As a formal system arrangement, long-term care insurance is a manifestation of socialized nursing responsibilities and plays an important role in supporting informal family care, effectively promoting the coordinated development between formal and informal care. The Netherlands, Germany, Japan, and South Korea are typical social long-term care insurance countries. This article explores their practical experience in supporting informal family care and proposes ideas and suggestions for long-term care insurance to support informal family care in the context of China.

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 systematically analyzes the mechanism of multi-agent collaboration enabled by digital technology in the long-term care service system, existing obstacles, and the construction path of an effective collaboration mechanism. Method: An integrative review method was employed to search the PubMed and Web of Science databases using the terms "multi-agent collaboration", "long-term care", and "digital technology", from the establishment of the databases to May 2025. We screened literature by establishing inclusion and exclusion criteria and 11 articles that met the requirements were ultimately included. The thematic analysis method was adopted to extract and integrate the literature data for analysis. Results: The multi-agent collaboration of long-term care service system from the perspective of digital technology can be divided into implementation dimensions and collaborative mechanisms. The implementation dimensions cover information flow, workflow, multi-agent collaboration and experience, obstacles and facilitating factors, opportunities and challenges, and construction paths. The collaborative mechanisms include the construction of a digital platform and a multi-agent dialogue mechanism. Conclusion: Digital technology offers an innovative path for multi-agent collaboration in long-term care service systems, but its effectiveness relies on the coordination of technology, organization, and policy.

Objective: The paper attempts to predict the demand for long-term care insurance among residents in Xinjiang Uygur Autonomous Region, analyze the influencing factors of long-term care insurance demand among urban and rural residents, and provide a reference for the comprehensive promotion of the long-term care insurance system. Method: The GM (1,1) grey correlation prediction model was used to predict the long-term care insurance demand of Xinjiang residents. Based on the grey correlation analysis model, the impact of different influencing factors on the long-term care insurance demand of urban and rural residents in Xinjiang was empirically analyzed. Results: From 2024 to 2030, the demand for long-term care insurance among residents in Xinjiang is expected to climb from 76100 people to 91700 people. The elderly dependency ratio and the proportion of people participating in basic medical insurance are important non-economic factors that affect the long-term care insurance demands of Xinjiang residents (correlation value ≥ 0.56). Interest rates and urban consumer price index (correlation value ≥ 0.75), as well as rural residents' pension and annual per capita disposable income (correlation value ≥ 0.7) are the main economic factors affecting the long-term care insurance demand of urban and rural residents. Conclusion: From 2024 to 2030, the demand for long-term care insurance among residents in Xinjiang has significantly increased, but the long-term care insurance policies need to be improved. It is recommended to coordinate and plan long-term care insurance policies, scientifically and reasonably design financing and payment mechanisms for long-term care insurance, and continuously meet the growing demands for long-term care insurance among residents.

Objective: The paper explores the system problems and countermeasures of long-term care insurance service supply with diversified service demands in China. Methods: Based on the symbiosis theory, this research analyzed the current long-term care service plan, nursing staff, government's financial support, long-term care insurance fund planning and other related issues, and discussed the feasibility and corresponding challenges of developing the symbiosis model of long-term care insurance system and expanding the social participation function. Results: The study focused on collaborative prospects and practical obstacles of the three symbiotic units of nursing system, social health system and community care, and further proposed a suitable path for the construction of the symbiotic mechanism of long-term care insurance service system from the perspectives of the power and responsibility distribution, the interest circulation and the resource supply. Conclusion: The study revealed that, from the perspective of a symbiotic system, the long-term care insurance system still faces several challenges, including the need to modify the symbiotic organizational model, lower industry access threshold within the system, enhance flexibility in service, and address the unrealized function of nursing resource absorption and sinking. It is imperative for the government to actively construct and refine the symmetrical-mutualistic symbiotic model, lower access threshold and deepen reforms in service payment policies to foster a symbiotic environment suitable for service expansion. By promoting information sharing and resource coordination, interactions among symbiotic units can be facilitated along with effective absorption-sinking functions.

Globally, the regulatory system for long-term care services has become an important part for ensuring the quality of long-term care services. On the basis of literature research, the content analysis of policy texts, this study compares the long-term care service quality supervision systems in Germany, Japan, South Korea from three dimensions of structure, process, outcome by the SPO model. The study found that the long-term care service quality supervision in Germany, Japan, South Korea has a clear division of government responsibility, a standardized access system of institutions, the setting of hierarchical classification of service personnel qualifications, multi-dimensional needs assessment, strict rating of service institutions, transparent information disclosure, regular satisfaction surveys. Therefore, drawing on the experience of Germany, Japan, South Korea in the long-term care service quality supervision system, China needs to further improve the regulatory legislation, implement the rating of designated nursing institutions, optimize the disability assessment tools, establish information disclosure systems to ensure the improvement of long-term care service quality

With the intensification of population aging in China and the continuous expansion of the disabled population, long-term care insurance (LTCI) has become the core institutional solution for mitigating disability risks. This study examines policy texts related to LTCI service programs across 49 pilot cities, comprehensively employing ROST CM6 and UCINET6 software for word frequency statistics, semantic network analysis, and centrality metrics analysis to explore policy element correlations and structural characteristics of the policy system. Findings reveal that "care recipients" "nursing care" "insurance" "assessment" and "assistance" constitute core policy elements, with high-frequency service programs focusing on basic nursing care, functional training, and health monitoring. On the whole, the policy system demonstrates three logical characteristics of "supply-demand coupling" "institutional coordination" and "professional support". Based on these findings, the study proposes a three-dimensional optimization framework encompassing dimensions of value, institution, and operation. This includes establishing dynamic assessment mechanisms to strengthen supply-demand matching, constructing contract-based governance systems to optimize institutional synergy, and promoting standardized yet differentiated services to enhance service efficiency. These recommendations aim to improve the nursing and security for disabled populations and refine China's social security system.

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.

China's pilot program for the long-term care insurance (LTCI) system initiated in 2016, still remains in the exploratory phase regarding funding mechanism construction, relevant policy requiring refinement. Drawing on historical experience from Germany, Japan, and South Korea, as well as practice from domestic pilot cities, this paper analyzes critical issues in constructing China's LTCI funding mechanism. It proposes establishing LTCI as an independent social insurance type, adopting a contributory model of insured entities, establishing financing mechanism with multi-stakeholder participation, and implementing a gradual promotion strategy for insurance coverage while incorporating actuarial mechanism to ensure the sustainable development of long-term care insurance.

With the accelerated population aging, optimizing the long-term care insurance system and service supply has become a key proposition for improving the social security system. As an institutionalized innovation in response to the silver hair wave, long-term care insurance has demonstrated remarkable effectiveness in safeguarding the health rights and interests of disabled elderly people, releasing the development momentum of families, and improving the social security system by establishing a professional care system. However, the long-term care insurance system is still in its early stage of development. During the implementation process, it is confronted with multiple predicaments such as fragmented systems, the absence of a hierarchical guarantee mechanism, low efficiency of resource integration, structural imbalance between supply and demand of nursing services, and weakened market supplementary functions. It is imperative to take the three-dimensional linkage of institutional innovation, technological empowerment, and market mechanisms as an important approach to build a long-term care system with full coverage, precise identification ofneeds, and professional stratification, and to steadily promote high-quality supply of long-term care insurance services, thereby facilitating the realization of the social governance goal of ensuring elderly care and providing high-quality care for the elderly.

Objective: To address the quality regulation of long-term care insurance services, this article analyses the quality regulation standards, process and intervention measures of long-term care service in the Netherlands, so as to provide lessons that can be learnt for improving the quality of long-term care insurance services in China. Methods: The article uses the text analysis method to collate measures and experience in the quality regulation of long-term care services in the Netherlands. Results: As one of the earliest countries to establish a social insurance system for long-term care, the Netherlands, while providing complex and various care services for people with care needs, adheres to the person-centered principle in quality regulation of care services, establishes a multi-sectoral system for quality regulation of care providers, sets up an open, transparent and punitive information collection system, and formulates systematically implemented quality regulation interventions. Conclusion: Quality regulation of long-term care services plays an important role in achieving the goals of long-term care insurance, managing long-term care insurance resources, and promoting the healthy and sustainable operation of long-term care insurance. Drawing on the experience of the Netherlands in quality regulation of long-term care services, China should build a person-centered quality regulation system of care services, pay attention to the management level of care providers, improve the informal care system, and build an information platform for quality regulation of long-term care services.

The increasingly serious aging of the population has prompted China to establish the long-term care insurance system, also it has become a catalyst for the silver economy. This paper takes Hohhot, a pilot city of long-term care insurance, as an example to analyze the effectiveness of the system and the problems such as low-quality of home care services, insufficient quantity of medical care services, gap between urban and rural care, and insufficient training of nursing staff. Focusing on the new development ideas of cultivating and developing the silver economy in Inner Mongolia Autonomous Region, this article explores the internal mechanism of mutual support and coordinated development between the silver economy and long-term care insurance, and puts forward thoughts and suggestions on the measures of the silver economy to promote the high-quality development of long-term care insurance.

There is a serious lack of theoretical and empirical research on the quality evaluation of long-term care services in China. To enrich the relevant research, this paper conducted an empirical evaluation on the quality of long-term care services in A City based on the OECD's long-term care service quality evaluation framework. The study found that the quality of institutional nursing services was in general higher than that of home care services. In terms of effectiveness and safety, the incidence of pressure sores and the rate of falls in home care services were higher than those in institutional nursing services. In terms of the patient-centered and responsive dimensions, the improvement rates of life control, response speed, social activities, disposable time, living environment, and feeling of support in home care services are all lower than those in institutional nursing services. To this end, the government needs to take various measures to further improve the quality of home care services, enhance the professionalism of home care to compensate for the shortcomings of family caregiving, and establish a nationwide quality assessment framework for long-term care services, thereby achieving continuous improvement in long-term care service quality.

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.

With the improvement of the long-term care insurance system, analysis of domestic pilot experience is crucial to the development of a model with Chinese characteristics. As one of the first pilot cities in China, Chengdu has gone through three stages of exploratory piloting, deepening implementation and systematic improvement over the past seven years. This evolution has not only deepened the connotation of the system, but also gradually constructed a financing mechanism with clear rights and responsibilities, a scientific and accurate assessment system, an extensive coverage of service provision, and an efficient and orderly management system. The purpose of this paper is to present the development history of the long-term care insurance system in Chengdu, distill the pilot experience and deficiencies in Chengdu through comparative analysis with the policies of other pilot cities in the five southwestern provinces, provide references for further optimizing the local long-term care insurance policy, and to provide useful insights for the top-level design of the national system.

The assessment of disability levels is a key link in the operation of the long-term care insurance system, and is the basis for the admission of eligibility for long-term care insurance benefits, the rational allocation of resources and the precise flow of funds. Throughout the world, countries that have implemented long-term care insurance systems have basically established a unified national assessment system. In order to break the fragmentation of disability assessment and build a unified national disability assessment system, pilot cities in China need to change the disability assessment mode and optimize the disability assessment mechanism, among which converting the main body of disability assessment and cultivating designated assessment agencies are the primary tasks. Based on the SWOT matrix, this paper analyzes the advantages, disadvantages, opportunities, and challenges of the designated assessment agencies' participation in disability assessment, and puts forward the optimization strategy by drawing on international experience, so as to provide references for optimizing the disability assessment model in pilot cities.

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.

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.

Obviously, the intensification of population aging brings challenges, but it also gives rise to new development opportunities in the silver economy. China encourages chain enterprises, listed companies to actively participate in the development of the pension industry, leveraging their resource advantages, leading roles, has achieved some accomplishments to date. This article takes Shanghai as an example to analyze the achievements, input-output differences, industrial cooperation effects of chain long-term care insurance designated service institutions in their investment in the pension industry. Also, with the thoughts on cultivating, developing the silver economy in China, it explores the role of chain long-term care insurance designated service institutions in resource integration, information sharing, industrial collaboration, providing ideas for chain enterprises, well-known brand companies in other key economic regions to participate in promoting the pension industry, offering guidance of direction for the development of the silver economy in central, western cities, thereby promoting the construction of multi-level, multi-subject development carriers for the silver economy

Objective: The paper studies the long-term trend of changes in the cost of percutaneous coronary intervention (PCI) before and after coronary stent centralized procurement, so as to evaluate the implementation effect of the centralized procurement policy, and propose policy recommendations. Methods: We extracted the cost data of the first page of medical records of discharged patients undergoing PCI in a tertiary comprehensive hospital in Ningbo City of Zhejiang Province from 2019 to 2024. The disease cost, composition ratio, and cost correlation degree were analyzed through structural change degree and grey correlation analysis, and statistical methods were used to analyze the changes in various costs before and after centralized procurement. Results: A total of 14476 discharged patients were included. The median cost of PCI before coronary stent centralized procurement (2019-2020) was 41559 yuan, which decreased to 28988 yuan in the initial period of centralized procurement(2021-2022), and further decreased to 25730 yuan in the long-term period of centralized procurement(2023-2024), showing a continuous downward trend with statistical significance (J-T=-38.63, P<0.001). From long-term data, it can be seen that after the implementation of the centralized coronary stent procurement policy, the structure of PCI disease expenses has remained basically stable, and the contribution rate of consumables to the structural changes of disease expenses is the highest at 50.00%. The highest correlation between drug costs and disease costs is 0.825. Conclusions: The policy of centralized procurement of coronary stents has a sustained effect on reducing the cost of PCI, and has a positive significance in achieving healthcare reform goals such as alleviating the "high cost of medical treatment" and increasing the proportion of medical service income. However, the increase in the proportion of medical service income mainly depends on the reduction of consumable costs. It is suggested to take advantage of the opportunity brought by centralized procurement to timely promote the reform of medical service price adjustment, scientifically formulate disease payment standards according to technical difficulty and risk, in order to avoid limitations on innovative technologies in clinical application.

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.

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.

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.

As typical representatives of vulnerable groups in rural areas, disabled elderly individuals face the issue of returning to poverty due to illness and poverty caused by illness, which has become a weak link in consolidating poverty alleviation achievements and promoting common prosperity. The implementation of long-term care insurance serves as a safety net to prevent rural elderly residents from returning to poverty due to illness and and poverty caused by illness. This paper constructs a multidimensional poverty indicator system for rural elderly residents and employs the A-F method in conjunction with data from the CHARLS 2020 survey for empirical analysis to explore the impact of long-term care insurance on multidimensional poverty among rural elderly residents. The study finds that long-term care insurance reduces the multidimensional poverty index of rural elderly residents by 0.028 and significantly decreases the risk of falling into economic and health poverty. Consequently, the paper proposes to expand the implementation scope of the long-term care insurance system, optimize the financing mechanism of long-term care insurance, and introduce professional home care services.