Field Epidemiology
Effect of long-term care insurance on incidence of falls in old people with disability based on difference-in-differences method
Liu Hongyun, Feng Chuanteng, Yu Bin, Ma Hua, Bai Yihong, Jia Peng, Dou Qingyu, Yang Shujuan
Published 2024-05-10
Cite as Chin J Epidemiol, 2024, 45(5): 673-678. DOI: 10.3760/cma.j.cn112338-20230913-00153
Abstract
ObjectiveTo analyze the effect of long-term care insurance on the incidence of falls in old people with disability, and the modification effect of different living arrangements.
MethodsBased on the discharge diagnosis records of the hospitalization in urban residents who applied for long-term care insurance in Chengdu from July 2014 to June 2021, those who received long-term care insurance were selected as the intervention group and those who received no long-term care insurance were selected as the control group, the changes in the incidence of falls before and after the long-term care were analyzed using difference-in-differences method, and the modification effects of different living arrangements were explored using stratified analysis.
ResultsLong-term care insurance significantly reduced the risk for monthly incidence of falls in older adults [average treatment effects on treated (ATT) = -1.21% (95%CI: -1.82%--0.60%)], and the effect increased over time (ATT=-1.26%, 95%CI: -1.93%--0.59%). Long-term care insurance had a significant effect on reducing the incidence of falls in old people living with spouses/family members (ATT=-0.92%, 95%CI: -1.47%--0.37%) and in nursing facilities/hospitals (ATT=-2.10%, 95%CI: -3.81%--0.40%), but it had no significant effect in those living alone.
ConclusionsLong-term care insurance can effectively reduce the incidence of falls in old people with disability, showing a positive effect. Living with family members or in nursing facilities/hospitals has a modification effect of the implementation of long-term care insurance policy. It is necessary to pay attention to key populations in the future and expand the coverage of long-term care insurance.
Key words:
Long-term care insurance; Old people with disability; Difference-in- differences method; Fall
Contributor Information
Liu Hongyun
West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
Feng Chuanteng
West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu 610207, China
Yu Bin
West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu 610207, China
Ma Hua
West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
Bai Yihong
Department of Epidemiology &
Biostatistics, Western University Ontario, Ontario N6G 2M1, Canada
Jia Peng
School of Resources and Environmental Sciences, Wuhan University, Wuhan 430072, China
Hubei Luojia Laboratory, Wuhan 430072, China
School of Public Health, Wuhan University, Wuhan 430071, China
International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
Dou Qingyu
National Clinical Medical Research Center for Geriatric Diseases/West China Hospital of Sichuan University, Chengdu 610041, China
Yang Shujuan
West China School of Public Health/The Fourth Hospital of West China, Sichuan University, Chengdu 610041, China
International Institute of Spatial Lifecourse Health, Wuhan University, Wuhan 430072, China
