Shaping Long-term Care Insurance Intentions Among Chinese Adults Aged 50-70: Role of Information Interventions in Health Risks

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Abstract Background and Objectives China’s population aging, especially increasing numbers of older people with disability and dementia, challenges the public health care system. Long-term care insurance (LTCI) is essential to provide care for China’s fast-growing aging population, yet there is a lack of evidence on how the health risks of disability and dementia influence the acceptance of LTCI in China. This study explores the effects of health risk information about disability or dementia on the LTCI intentions of the Chinese aged 50-70. Research Design and Methods Using stratified random sampling and convenience sampling methods, we designed a survey of 1025 respondents aged 50-70 from 8 provinces in China. We randomly assigned respondents to control (n=354), disability risk (n=339) and dementia risk (n=332) groups, and used multinomial logit models to investigate the information intervention effects on respondents’ different LTCI (No/Uncertain/Yes) intentions. Also, we analyzed the heterogeneity of respondents’ education level and whether living in LTCI pilot/non-pilot policy cities. Results Both disability and dementia risk information significantly decreased the probability that respondents were unwilling relative to being willing to enroll in LTCI. The marginal prediction results show that pre-test LTCI intentions played a key role in shaping post-intention LTCI. In the analysis of heterogeneity, we found that disability information was associated with an increased likelihood of respondents with lower levels of education answering “uncertain”, and dementia information was associated with a decreased likelihood of answering “no” for respondents living in the LTCI pilot policy cities. Discussion and Implications Disability and dementia risk interventions significantly improved LTCI intentions among Chinese aged 50-70. To improve the acceptance of LTCI, we recommend that policymakers adopt the strategies of information interventions for LTCI policy advocacy and differentiate dementia-related and disability-related risk information by individuals with different educational levels and residents in LTCI pilot/non-pilot policy cities.