Study on appropriateness of long⁃term care insurance financing levels based on the coupling coordination degree

ObjectiveTo focus on the appropriateness of long⁃term care insurance(LTCI) financing levels. It measured the coordination between LTCI financing levels and regional economic capacity,as well as aging pressure.The goal is to provide empirical evidence and policy recommendations for sustainable LTCI development.MethodsWe built a coupling coordination degree model with three subsystems:financing level,economic development,and population structure.We selected three cities as samples:city X(northern Jiangsu),city N(central Jiangsu),and city C(southern Jiangsu).Data came from field surveys, statistical yearbooks,and government reports.We used the entropy method to determine indicator weights.We calculated composite indices for each subsystem and assessed the coupling coordination levels.ResultsThe results showed significant regional differences and dynamic changes.City N improved steadily and reached a "barely coordinated" stage.City X remained trapped in a state of "slight imbalance" at the antagonistic stage, plagued by the "scissors effect" between fixed⁃amount financing, population outflow,and rising service costs.In contrast,economically developed city C experienced a mismatch between high economic carrying capacity and low financing levels due to the rigid model of "fixed contributions coupled with medical insurance dependency," causing its coupling coordination degree to shift from "slight imbalance" to "on the verge of imbalance".ConclusionsThe appropriateness of LTCI financing depends on multiple factors.These include financing mechanisms,population structure,and payment structures.It is also closely linked to regional economic development.We recommend establishing a long⁃term "proportional financing+dynamic adjustment" mechanism.We also suggest implementing region⁃specific strategies based on a two⁃dimensional matrix of "economic level+aging degree".Finally,we propose optimizing the linkage between payment structures and financing mechanisms.