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Linhong Chen
School of Mathematics and Statistics, Chongqing Technology and Business University, Chongqing, 400067, China

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Review
Published: 20 November 2020 in BMC Health Services Research
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Background The growing demand for LTC (Long-term care) services for disabled elderly has become a daunting task for countries worldwide, especially China, where population aging is particularly severe. According to CSY (China Statistical Yearbook,2019), the elderly aged 65 or above has reached 167 million in 2018, and the number of disabled elderly is as high as 54%. Germany and other countries have alleviated the crisis by promoting the public LTCI (Long-Term Care Insurance) system since the 1990s, while China’s public LTCI system formal pilot only started in 2016. Therefore, the development of the public LTCI system has gradually become a hot topic for scholars in various countries, including China. Methods This review has been systematically sorted the existing related literature to discuss the development of public LTCI (Long-Term Care Insurance)system form four aspects, namely, the comparison of public LTCI systems in different countries, the influence of public LTCI, challenge of public LTCI, and the relationship between public LTCI and private LTCI. We searched some databases including Web of Science Core Collection, Medline, SCOPUS, EBSCO, EMBASE, ProQuest and PubMed from January 2008 to September 2020. The quality of 38 quantitative and 21 qualitative articles was evaluated using the CASP(Critical Appraisal Skills Programme) critical evaluation checklist. Results The review systematically examines the development of public LTCI system from four aspects, namely, the comparison of public LTCI systems in different countries, the influence of public LTCI, the challenge of public LTCI, and the relationship between public LTCI and private LTCI. For example, LTCI has a positive effect on the health and life quality of the disabled elderly. However, the role of LTCI in alleviating the financial burden on families with the disabled elderly may be limited. Conclusion Some policy implications on the future development of China’s LTCI system can be obtained. For example, the government should fully consider the constraints such as price rise, the elderly disability rate, and the substantial economic burden. It also can strengthen the effective combination of public LTCI and private LTCI. It does not only help to expand the space for its theoretical research but also to learn the experiences in the practice of the LTCI system in various countries around the world. It will significantly help the smooth development and further promote the in-depth reform of the LTCI system in China.

ACS Style

Linhong Chen; Lu Zhang; Xiaocang Xu. Review of evolution of the public long-term care insurance (LTCI) system in different countries: influence and challenge. BMC Health Services Research 2020, 20, 1 -21.

AMA Style

Linhong Chen, Lu Zhang, Xiaocang Xu. Review of evolution of the public long-term care insurance (LTCI) system in different countries: influence and challenge. BMC Health Services Research. 2020; 20 (1):1-21.

Chicago/Turabian Style

Linhong Chen; Lu Zhang; Xiaocang Xu. 2020. "Review of evolution of the public long-term care insurance (LTCI) system in different countries: influence and challenge." BMC Health Services Research 20, no. 1: 1-21.

Journal article
Published: 06 May 2020 in Healthcare
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Purpose: As an important measure to alleviate long-term care (LTC) costs for the disabled due to the aging of the population, long-term care insurance (LTCI) system has been paid more attention in China. In addition to the government-led public LTCI system that has been piloted in cities such as Qingdao, Chongqing and Shanghai, health insurers such as the China Life Insurance Company are also experimenting with various types of commercial LTCI in the private market. However, the commercial LTCI market is developing very slowly due to public awareness and other reasons. On the other hand, COVID-2019 has had an impact on the cognition of the importance of long-term care for the elderly due to the fact that the death cases of COVID-2019 have been mainly concentrated in the elderly population with chronic diseases such as hypertension. Therefore, the purpose of this study is to explore the differences in the purchase intention of commercial LTCI among the elderly in two different periods: before and after the outbreak of COVID-2019. Methods: By using the Andersen behavioral model and two investigations in two different periods before and after the outbreak of COVID-2019, this study explores the impacts of COVID-2019 on the purchase intention of commercial LTCI. Results: Some significant discoveries were found. For example, 25.8% of interviewees showed purchase intention in LTCI in the time before the COVID-2019 outbreak, while this proportion increased to 37.6% after the COVID-2019 outbreak. People who were younger (OR = 2.128, before COVID-2019; OR = 1.875, after COVID-2019) or who had more education (OR = 1.502, before COVID-2019; OR = 2.218, after COVID-2019) were more interested in commercial LTCI. Conclusion: This study shows that COVID-2019 has had an obvious impact on the purchase intention of commercial LTCI, which provides some enlightenment for China to improve the LTCI system in the future, especially to accelerate the development of commercial LTCI. For example, it is essential to promote the importance of long-term care among the elderly in a focused and targeted way. In terms of the key target audience, it can be developed gradually from the groups with higher education levels and the middle elderly aged 45–64 years old.

ACS Style

Xiaocang Xu; Lu Zhang; Linhong Chen; Feng Wei. Does COVID-2019 have an Impact on the Purchase Intention of Commercial Long-Term Care Insurance among the Elderly in China? Healthcare 2020, 8, 126 .

AMA Style

Xiaocang Xu, Lu Zhang, Linhong Chen, Feng Wei. Does COVID-2019 have an Impact on the Purchase Intention of Commercial Long-Term Care Insurance among the Elderly in China? Healthcare. 2020; 8 (2):126.

Chicago/Turabian Style

Xiaocang Xu; Lu Zhang; Linhong Chen; Feng Wei. 2020. "Does COVID-2019 have an Impact on the Purchase Intention of Commercial Long-Term Care Insurance among the Elderly in China?" Healthcare 8, no. 2: 126.

Journal article
Published: 04 May 2020 in Agriculture
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The decision in 2006 to abolish the agricultural tax, which had lasted for thousands of years, contributed to the prosperity of agriculture, and with it the growing importance of soil N2O emissions in China. However, most of the previous literature ignored soil N2O emissions due to their too small share in total agricultural greenhouse gas (GHG) emissions. This paper attempts to take soil N2O emissions as an important variable in the measurement of agricultural green total factor productivity (AGTFP), which incorporates environmental pollution into the analytical framework of agricultural production efficiency. Three impressive results were found. Firstly, soil N2O emissions play an increasingly important role in agricultural GHG emissions. The proportion of soil N2O emissions in agricultural GHG emissions increased from 4.52% in 1998 to 4.83% in 2006, and then to 5.36% in 2016. Secondly, the regional difference of soil N2O emissions in AGTFP is visible. In 2016, although soil N2O emissions accounted for a small proportion (about 5%) of the total agricultural GHG emissions in China, the AGTFP including soil N2O emissions was much lower than that excluding soil N2O emissions, especially in areas with high agricultural and population density. Finally, over time, soil N2O emissions have had an increasing effect on AGTFP. Compared with 1998–2006, the impact of excluding soil N2O emissions on AGTFP in 2007–2016 was more evident than that including soil N2O emissions.

ACS Style

Xiaocang Xu; Lu Zhang; Linhong Chen; Chengjie Liu. The Role of Soil N2O Emissions in Agricultural Green Total Factor Productivity: An Empirical Study from China around 2006 when Agricultural Tax Was Abolished. Agriculture 2020, 10, 150 .

AMA Style

Xiaocang Xu, Lu Zhang, Linhong Chen, Chengjie Liu. The Role of Soil N2O Emissions in Agricultural Green Total Factor Productivity: An Empirical Study from China around 2006 when Agricultural Tax Was Abolished. Agriculture. 2020; 10 (5):150.

Chicago/Turabian Style

Xiaocang Xu; Lu Zhang; Linhong Chen; Chengjie Liu. 2020. "The Role of Soil N2O Emissions in Agricultural Green Total Factor Productivity: An Empirical Study from China around 2006 when Agricultural Tax Was Abolished." Agriculture 10, no. 5: 150.

Journal article
Published: 03 December 2019 in Healthcare
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The rapid growth of population aging makes providing adequate long-term care (LTC) services for the elderly a serious social dilemma in China. Thus, it is necessary to carry out a theoretical discussion on the LTC service needs of the elderly and find out their influencing factors. With four regions of the middle and upper reaches of the Yangtze River as the sample case, this study aims to explore the factors that affect LTC service needs of the elderly in the frame of the latest Anderson Model, which added psychosocial factors to predisposing characteristics, enabling factors, and need factors in the old version. Some interesting results have been found, for example, self-image evaluation is composed of several factors such as general physical health, attitude towards life, or psychosocial states. Finally, sub-analyses—namely, by age, by gender, and by educational level—were carried out since the choice of different long-term care service patterns is related to different age/gender/education groups.

ACS Style

Liao Zeng; Xiaocang Xu; Chunxun Zhang; Linhong Chen. Factors Influencing Long-Term Care Service Needs among the Elderly Based on the Latest Anderson Model: A Case Study from the Middle and Upper Reaches of the Yangtze River. Healthcare 2019, 7, 157 .

AMA Style

Liao Zeng, Xiaocang Xu, Chunxun Zhang, Linhong Chen. Factors Influencing Long-Term Care Service Needs among the Elderly Based on the Latest Anderson Model: A Case Study from the Middle and Upper Reaches of the Yangtze River. Healthcare. 2019; 7 (4):157.

Chicago/Turabian Style

Liao Zeng; Xiaocang Xu; Chunxun Zhang; Linhong Chen. 2019. "Factors Influencing Long-Term Care Service Needs among the Elderly Based on the Latest Anderson Model: A Case Study from the Middle and Upper Reaches of the Yangtze River." Healthcare 7, no. 4: 157.

Journal article
Published: 18 October 2019 in International Journal of Environmental Research and Public Health
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As a result of China’s economic growth, air pollution, including carbon dioxide (CO2) emission, has caused serious health problems and accompanying heavy economic burdens on healthcare. Therefore, the effect of carbon dioxide emission on healthcare expenditure (HCE) has attracted the interest of many researchers, most of which have adopted traditional empirical methods, such as ordinary least squares (OLS) or quantile regression (QR), to analyze the issue. This paper, however, attempts to introduce Bayesian quantile regression (BQR) to discuss the relationship between carbon dioxide emission and HCE, based on the longitudinal data of 30 provinces in China (2005–2016). It was found that carbon dioxide emission is, indeed, an important factor affecting healthcare expenditure in China, although its influence is not as great as the income variable. It was also revealed that the effect of carbon dioxide emission on HCE at a higher quantile was much smaller, which indicates that most people are not paying sufficient attention to the correlation between air pollution and healthcare. This study also proves the applicability of Bayesian quantile regression and its ability to offer more valuable information, as compared to traditional empirical tools, thus expanding and deepening research capabilities on the topic.

ACS Style

Linhong Chen; Yue Zhuo; Xu; Xin Gao; Chen; Zhuo; Gao; Zhiming Xu; Xiaocang Xu. Is Carbon Dioxide (CO2) Emission an Important Factor Affecting Healthcare Expenditure? Evidence from China, 2005–2016. International Journal of Environmental Research and Public Health 2019, 16, 3995 .

AMA Style

Linhong Chen, Yue Zhuo, Xu, Xin Gao, Chen, Zhuo, Gao, Zhiming Xu, Xiaocang Xu. Is Carbon Dioxide (CO2) Emission an Important Factor Affecting Healthcare Expenditure? Evidence from China, 2005–2016. International Journal of Environmental Research and Public Health. 2019; 16 (20):3995.

Chicago/Turabian Style

Linhong Chen; Yue Zhuo; Xu; Xin Gao; Chen; Zhuo; Gao; Zhiming Xu; Xiaocang Xu. 2019. "Is Carbon Dioxide (CO2) Emission an Important Factor Affecting Healthcare Expenditure? Evidence from China, 2005–2016." International Journal of Environmental Research and Public Health 16, no. 20: 3995.

Journal article
Published: 16 October 2019 in International Journal of Environmental Research and Public Health
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Environmental costs should be taken into account when measuring the achievements of China’s agricultural development, since the long-term extensive development of agriculture has caused huge environmental pollution. This study took agricultural carbon emissions as an undesired output to estimate the agricultural development efficiency in 31 provinces of China from 1998 to 2016, based on the green total factor productivity, as assessed by the slacks-based measure directional distance function and constructing the global Malmquist–Luenberger index. We measured agricultural carbon emissions in terms of five aspects: agricultural materials, rice planting, soil, livestock and poultry farming, and straw burning, and then compared the green total factor productivity index and the total factor productivity index. The study came to the following conclusions: (1) the green technology efficiency change was smaller than the technology efficiency change at first, but the gap between them is narrowing with time, such that the former is now larger than the latter; (2) the green technology efficiency was in a declining state and the green technology progress was increasing, promoting the green total factor productivity growth, from 1998 to 2016; and (3) China’s agricultural green total factor productivity increased by 4.2% annually in the east, 3.4% annually in the central region, and 2.5% annually in the west.

ACS Style

Xiaocang Xu; Xiuquan Huang; Jun Huang; Xin Gao; Linhong Chen. Spatial-Temporal Characteristics of Agriculture Green Total Factor Productivity in China, 1998–2016: Based on More Sophisticated Calculations of Carbon Emissions. International Journal of Environmental Research and Public Health 2019, 16, 3932 .

AMA Style

Xiaocang Xu, Xiuquan Huang, Jun Huang, Xin Gao, Linhong Chen. Spatial-Temporal Characteristics of Agriculture Green Total Factor Productivity in China, 1998–2016: Based on More Sophisticated Calculations of Carbon Emissions. International Journal of Environmental Research and Public Health. 2019; 16 (20):3932.

Chicago/Turabian Style

Xiaocang Xu; Xiuquan Huang; Jun Huang; Xin Gao; Linhong Chen. 2019. "Spatial-Temporal Characteristics of Agriculture Green Total Factor Productivity in China, 1998–2016: Based on More Sophisticated Calculations of Carbon Emissions." International Journal of Environmental Research and Public Health 16, no. 20: 3932.

Journal article
Published: 26 August 2019 in International Journal of Environmental Research and Public Health
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Despite achieving remarkable development, China's agricultural economy has been under severe environmental pressure. Based on previous studies, the present study further considers the sources of agricultural carbon emissions in depth, estimates China's agricultural carbon emissions from 1997 to 2016, and analyzes the agricultural pollution faced by China and its provinces. The study estimates the amount and intensity of agricultural carbon emissions in China from five carbon sources-agricultural materials, rice planting, soil N2O, livestock and poultry farming, and straw burning-and analyzes their spatial and temporal characteristics. The following results were obtained: (1) between 1997 and 2016, the amount of agricultural carbon emissions in China generally increased, while the intensity of agricultural carbon emissions decreased; (2) in the same period, the amount of carbon emissions from each category of carbon source generally increased, with the exception of rice planting; however, the amount of emissions fluctuated; (3) the amount and intensity of carbon emissions varied greatly among provinces; (4) the emissions from different categories of carbon source showed different concentration trends and agglomeration forms; (5) China's agricultural carbon emissions showed obvious spatial correlation, which overall was high-high agglomeration; however, its carbon emissions gradually weakened, and the spatial agglomeration of agricultural carbon emissions in each province changed between 1997 and 2016.

ACS Style

Xiuquan Huang; Xiaocang Xu; Qingqing Wang; Lu Zhang; Xin Gao; Linhong Chen. Assessment of Agricultural Carbon Emissions and Their Spatiotemporal Changes in China, 1997-2016. International Journal of Environmental Research and Public Health 2019, 16, 3105 .

AMA Style

Xiuquan Huang, Xiaocang Xu, Qingqing Wang, Lu Zhang, Xin Gao, Linhong Chen. Assessment of Agricultural Carbon Emissions and Their Spatiotemporal Changes in China, 1997-2016. International Journal of Environmental Research and Public Health. 2019; 16 (17):3105.

Chicago/Turabian Style

Xiuquan Huang; Xiaocang Xu; Qingqing Wang; Lu Zhang; Xin Gao; Linhong Chen. 2019. "Assessment of Agricultural Carbon Emissions and Their Spatiotemporal Changes in China, 1997-2016." International Journal of Environmental Research and Public Health 16, no. 17: 3105.

Journal article
Published: 21 August 2019 in Healthcare
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Chronic diseases among the elderly and their huge economic burden on family have caught much attention from economists and sociologists over the past decade in China. This study measured the economic burden of elderly chronic disease (ECD) in families using the China Health and Retirement Longitudinal Study (CHARLS) data set from Peking University (China). We studied some aspects of this burden, including health-service utilization, out-of-pocket expenditure on inpatient and outpatient, total family expenditures on items, and labor force participation rates of family members, etc. Some interesting things were found, for example, the additional annual expenditure on inpatient care (per member) in ECD-families was 37 to 45 percent of the annual expenditure in the control group; the labor-force participation rate in ECD-families was 2.4 to 3.3 percent of points lower than in the control group.

ACS Style

Xiaocang Xu; Xiuquan Huang; Xiaolu Zhang; Linhong Chen. Family Economic Burden of Elderly Chronic Diseases: Evidence from China. Healthcare 2019, 7, 99 .

AMA Style

Xiaocang Xu, Xiuquan Huang, Xiaolu Zhang, Linhong Chen. Family Economic Burden of Elderly Chronic Diseases: Evidence from China. Healthcare. 2019; 7 (3):99.

Chicago/Turabian Style

Xiaocang Xu; Xiuquan Huang; Xiaolu Zhang; Linhong Chen. 2019. "Family Economic Burden of Elderly Chronic Diseases: Evidence from China." Healthcare 7, no. 3: 99.

Journal article
Published: 01 August 2019 in International Journal of Environmental Research and Public Health
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Industrial development has brought about not only rapid economic growth, but also serious environmental pollution in China, which has led to serious health problems and heavy economic burdens on healthcare. Therefore, the relationship between the industrial air pollution and health care expenditure (HCE) has attracted the attention of researchers, most of which used the traditional empirical methods, such as ordinary least squares (OLS), logistic and so on. By collecting the panel data of 30 provinces of China during 2005-2016, this paper attempts to use the Bayesian quantile regression (BQR) to reveal the impact of industrial air pollution represented by industrial waste gas emission (IWGE) on HCE in high-, middle-, low-income regions. It was found that double heterogeneity in the influence of IWGE on HCE was obvious, which revealed that people in high-, middle-, low-income regions have significantly different understandings of environmental pollution and health problems. In addition, the BQR method provided more information than the traditional empirical methods, which verified that the BQR method, as a new empirical method for previous studies, was applicable in this topic and expanded the discussion space of this research field.

ACS Style

Xiaocang Xu; Zhiming Xu; Linhong Chen; Chang Li. How Does Industrial Waste Gas Emission Affect Health Care Expenditure in Different Regions of China: An Application of Bayesian Quantile Regression. International Journal of Environmental Research and Public Health 2019, 16, 2748 .

AMA Style

Xiaocang Xu, Zhiming Xu, Linhong Chen, Chang Li. How Does Industrial Waste Gas Emission Affect Health Care Expenditure in Different Regions of China: An Application of Bayesian Quantile Regression. International Journal of Environmental Research and Public Health. 2019; 16 (15):2748.

Chicago/Turabian Style

Xiaocang Xu; Zhiming Xu; Linhong Chen; Chang Li. 2019. "How Does Industrial Waste Gas Emission Affect Health Care Expenditure in Different Regions of China: An Application of Bayesian Quantile Regression." International Journal of Environmental Research and Public Health 16, no. 15: 2748.

Journal article
Published: 27 June 2019 in Sustainability
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The aging population in China highlights the significance of elderly long-term care (LTC) services. The number of people aged 65 and above increased from 96 million in 2003 to 150 million in 2016, some of whom were disabled due to chronic diseases or the natural effects of aging on bodily functions. Therefore, the measurement of future LTC costs is of crucial value. Following the basic framework but using different empirical methods from those presented in previous literature, this paper attempts to use the Bayesian quantile regression (BQR) method, which has many advantages over traditional linear regression. Another innovation consists of setting and measuring the high, middle, and low levels of LTC cost prediction for each disability state among the elderly in 2020–2050. Our projections suggest that by 2020, LTC costs will increase to median values of 39.46, 8.98, and 20.25 billion dollars for mild, moderate, and severe disabilities, respectively; these numbers will reach 141.7, 32.28, and 72.78 billion dollars by 2050. The median level of daily life care for mild, moderate, and severe disabilities will increase to 26.23, 6.36, and 27 billion dollars. Our results showed that future LTC cost increases will be enormous, and therefore, the establishment of a reasonable individual-social-government payment mechanism is necessary for the LTC system. The future design of an LTCI system must take into account a variety of factors, including the future elderly population, different care conditions, the financial burden of the government, etc., in order to maintain the sustainable development of the LTC system.

ACS Style

Xiaocang Xu; Linhong Chen. Projection of Long-Term Care Costs in China, 2020–2050: Based on the Bayesian Quantile Regression Method. Sustainability 2019, 11, 3530 .

AMA Style

Xiaocang Xu, Linhong Chen. Projection of Long-Term Care Costs in China, 2020–2050: Based on the Bayesian Quantile Regression Method. Sustainability. 2019; 11 (13):3530.

Chicago/Turabian Style

Xiaocang Xu; Linhong Chen. 2019. "Projection of Long-Term Care Costs in China, 2020–2050: Based on the Bayesian Quantile Regression Method." Sustainability 11, no. 13: 3530.