Direct and spillover effects of long-term care insurance on Chinese elderly frailty

Frailty has become a pressing public health concern within the elderly population. However, the extent to which long-term care insurance (LTCI) coverage can alleviate frailty among elderly beneficiaries is still insufficiently explored. Utilizing data from the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS) and the city-by-city rollout of the LTCI program, this study examines the impact of China's LTCI policy on the frailty of older beneficiaries and their spouses. Our findings reveal a statistically significant reduction in frailty among older beneficiaries three to five years after LTCI implementation. Moreover, these positive effects extend to spouses, as indicated by a decreased frailty index among them. Notably, the benefits are more pronounced among beneficiaries and spouses who are male, reside in rural areas, and have lower levels of education and consumption. The reduction in frailty is primarily attributed to enhanced subjective well-being and reduced financial strain among beneficiaries, rather than increased utilization of long-term care services.