Mediation Effect Test of Financial Risk Pathways.

BackgroundWith the rapid progression of aging, mental health challenges among the elderly have become increasingly pronounced. Addressing these issues is vital for enhancing older adults’ quality of life and maintaining social stability. This study investigates the impact of China’s Critical Illness Insurance (CII) policy, a pivotal component of the national healthcare system, on the mental health of older adults.MethodsThis study leverages data from the China Health and Retirement Longitudinal Study (CHARLS) and utilizes the staggered implementation of the CII policy across regions as a “quasi-natural experiment.” A multi-period difference-in-differences (DID) approach is employed to estimate the policy’s effects. The analysis focuses on depression tendencies and scores among older adults, controlling for key sociodemographic and economic covariates.ResultsThe findings reveal three key insights: The CII policy significantly reduced depressive tendencies and depression scores among older adults, demonstrating marked improvements in their mental health.The policy effects exhibit substantial heterogeneity, with more pronounced benefits observed among middle- and high-income groups, individuals with chronic illnesses, and older adults in central and western regions.Mechanism analysis indicates that the policy alleviates psychological distress and enhances household financial stability by increasing access to healthcare services, sharing medical expenses, and mitigating financial risks.ConclusionThe CII policy has proven effective in improving the mental health of older adults, with significant variations across income levels, health conditions, and regional economic development. By reducing financial stress and improving access to healthcare, the policy not only addresses mental health disparities but also bolsters household economic resilience. These findings underscore the critical importance of tailored health insurance policies to address the diverse needs of an aging population effectively.

研究背景
随着人口老龄化进程的快速推进，老年人心理健康问题愈发凸显。妥善应对此类挑战，对于提升老年人生活质量、维护社会稳定具有关键意义。本研究聚焦于我国国家医疗保障体系的核心组成部分——大病保险（Critical Illness Insurance, CII）政策，探究其对老年人心理健康的影响。
研究方法
本研究采用中国健康与养老追踪调查（China Health and Retirement Longitudinal Study, CHARLS）的数据，并以各地区分阶段推行的大病保险政策作为“准自然实验”，运用多期双重差分法（multi-period difference-in-differences, DID）估计该政策的实施效应。分析以老年人的抑郁倾向与抑郁得分为核心指标，同时控制了关键的社会人口学与经济协变量。
研究结果
本研究得到三项核心发现：其一，大病保险政策显著降低了老年人的抑郁倾向与抑郁得分，有效改善了其心理健康水平；其二，政策效应存在显著异质性，中高收入群体、慢性病患者以及中西部地区老年人从中获得的收益更为显著；其三，机制分析显示，该政策通过扩大医疗服务可及性、分担医疗支出、化解财务风险，缓解了老年人的心理负担，提升了家庭财务稳定性。
研究结论
大病保险政策已被证实可有效改善老年人的心理健康水平，且政策效果因收入水平、健康状况与地区经济发展水平的不同而存在显著差异。该政策通过减轻财务压力、优化医疗服务可及性，不仅缩小了心理健康领域的差距，还增强了家庭经济韧性。本研究结果凸显了定制化健康保险政策的重要性，可有效应对老龄化社会中多样化的群体需求。