China's long-term care insurance programme significantly reduces the financial burden of health and care costs for older adults with cognitive and physical limitations according to a new study by King's College London.
The research paper Can long-term care insurance reduce catastrophic health and long-term care expenditures among older adults. A quasi-experimental study conducted by researchers from the department of Global Health and Social Medicine is among the first to show that the insurance programme can reduce the risks of a rapidly ageing population, devastating out-of-pocket costs and surging medical inflation—though only if eligibility criteria are inclusive, and reimbursement rates are sufficient.
King’s College PhD student and lead author of the study Chengxu Long said, “Traditional measures underestimate the true financial burden faced by older adults with disabilities. Our study shows that long-term care insurance can offer meaningful protection - especially for those with severe cognitive impairments or chronic conditions.”
Co-author Dr Wei Yang said, “This research has global relevance. Countries across the Global South are grappling with aging populations and rising care needs. China’s experience offers valuable lessons.”
The study published in June 2025 in the European Journal of Ageing analysed data from the China Health and Retirement Longitudinal Study spanning 2011 to 2018, focusing on 9,312 individuals aged 60 and above with cognitive or physical limitations.
The study introduces the concept of Catastrophic Health and Long-Term Care Expenditures (CHLTCE), a comprehensive measure that includes not only healthcare costs but also formal and informal long-term care expenses.
It found that informal care costs, often overlooked, make up a significant portion of household financial strain. Long-term insurance coverage reduced the risk of catastrophic expenditures by up to 18% at high thresholds, and the protective effect was strongest for individuals with severe cognitive impairments and those with both physical limitations and chronic diseases.
However, the programme had limited impact for those with milder impairments or without chronic conditions. Professor of Gerontology Dr Karen Glaser said their study highlights the need for policymakers to expand long-term insurance eligibility to include those with mild cognitive impairments.
She said, “They should also look at adjusting benefits to reflect complex care needs, not just physical disability. We also recommend increasing reimbursement rates to provide more comprehensive financial protection for vulnerable populations.”