ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1661785
How to evaluate long-term care insurance policy based on policy tools and PMC index model: Evidence from pilot cities in China
Provisionally accepted
- 1Dalian Medical University, Dalian, China
- 2Jiangxi University of Traditional Chinese Medicine, Nanchang, China
- 3Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, China
- 4The First Hospital of China Medical University, Shenyang, China
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Objective: To address the risk of disability arising from population aging, the long-term care insurance (LTCI) policy in China has been progressively piloted and expanded. This study aims to examine the tool combination and strengths and weaknesses of the LTCI policy through a textual quantitative analysis of policies issued in 29 pilot cities, thereby providing a reference for refining the policy framework. Methods: Seventy-nine LTCI policies were analyzed based on the two-dimensional analytical framework regarding policy tools and policy ratings. Policy texts were coded and analyzed according to the connotative elements of supply-, environment- and demand-based policy tools, while policy ratings with strengths and weaknesses were analyzed according to the Policy Modeling Consistency (PMC) index model. Results: LTCI policies of the 29 pilot cities all showed that the use of environment-based policy tools accounted for more than 70%, and supply- and demand-based policy tools ranged from 10% to 16%. The mean of the PMC index for the 79 policies was 7.701, with low scores across variables such as policy timeliness, policy level, and incentive and constraint, and an overall policy rating of good. Among these, the policies issued by the second batch of pilot cities had the highest PMC index value of 7.781. Conclusion: Pilot cities were over-utilizing environment-based policy tools and under-utilizing supply- and demand-based policy tools, which can be attributed to the reliance on environmental shaping during the policy pilot phase. LTCI policies of pilot cities can promote the development and improvement of the LTCI system, but there is still room for refinement in terms of policy authority, timeliness, coverage, and incentive measures. LTCI policies of the second batch of pilot cities were rated relatively higher, with higher-rated policies making more even use of various policy tools.
Keywords: long-term care insurance, Policy evaluation, policy tools, PMC index model, Pilot cities, China
Received: 11 Jul 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Wang, Wang, Yichun, Yuan, Wu, Shengnan, Luo and An. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Gu Yichun, guyichun@shdrc.org
Ni Yuan, nier1209@163.com
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