马琦峰,宁晶

• 1:中国人民大学人口与健康学院
• 2:对外经济贸易大学政府管理学院

摘要(Abstract)：

本研究基于政策反馈理论，使用中国老年社会追踪调查数据，运用倾向值得分匹配与渐进双重差分模型，考察长期护理保险对老年人养老责任偏好的政策影响。研究发现，长护险增强了老年人的社会化养老责任倾向，其影响通过资源、解释与学习三种政策反馈机制实现，在家庭照护负担较重、所在地区政策宣导力度较强及享受过待遇保障的群体中更突出。相关发现揭示了政策在非政治观念领域的溢出效应，并基于中国长护险“普惠筹资-精准给付”的混合型制度与老年群体非政治活跃性的独特情境，深化了对政策反馈机制多样性及情境依赖性的理论认知，为政策反馈理论在非西方福利体制下的发展提供了新的实证支持。在未来长护险试点推进过程中，政府需积极回应老年人的社会化养老期待，同时重视并发挥家庭照护的基础性作用。

关键词(KeyWords)： 长期护理保险;养老责任偏好;老年人;政策反馈理论;溢出效应

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目“人工智能政策叙事与公众反馈效应:基于地方政府的实证研究”(项目批准号:72304066);; 教育部人文社会科学重点研究基地项目“治理视域下中国政府部门与社会组织合作关系研究”(项目批准号:22JJD630002);; 中国人民大学2026年度拔尖创新人才培育资助计划的资助

作者(Author): 马琦峰,宁晶

参考文献(References)：

• 陈济冬,王磊,臧雷振.2024.保障性住房政策促进基层善治:基于政策反馈理论的实证探索[J].经济社会体制比较,(2):107-118.Chen J D,Wang L,Zang L Z.2024.Enhancing local governance through affordable housing policy:An empirical study from the policy feedback perspective[J].Comparative Economic&Social Systems,(2):107-118.(in Chinese) 丁志宏,陈硕,夏咏荷.2021.我国独生子女父母养老责任认知状况及影响因素研究[J].兰州学刊,(1):168-186.Ding Z H,Chen S,Xia Y H.2021.Study on the cognitive status and influencing factors of pension responsibility among only-child parents in China[J].Lanzhou Academic Journal,(1):168-186.(in Chinese) 杜鹏,马琦峰.2025.中国老龄问题研究年谱[J].江南大学学报(人文社会科学版),24(2):94-116.Du P,Ma Q F.2025.Chronological research on aging issues in China[J].Journal of Jiangnan University(Humanities&Social Sciences),24(2):94-116.(in Chinese) 范梓腾,宁晶.2021.技术变革中的福利态度转变---自动化替代对个体养老责任偏好的影响[J].社会学研究,36(1):160-179,229.Fan Z T,Ning J.2021.Technological change and welfare attitude:How automation replacement affects individuals'eldercare preferences[J].Sociological Studies,36(1):160-179,229.(in Chinese) 郭磊.2024.目标群体异质性影响政策遵从的双重机制研究---以企业养老保险缴费所有制差异为例[J].甘肃行政学院学报,(1):90-99,127.Guo L.2024.The dual mechanisms of heterogeneity between target groups affecting policy compliance:The case of ownership gap in enterprises'contributions to pension insurance[J].Journal of Gansu Administration Institute,(1):90-99,127.(in Chinese) 郭跃,何林晟,苏竣.2020.“工具叙事反馈”:一个行为公共政策的研究框架[J].中国行政管理,(5):71-78.Guo Y,He L S,Su J.2020.Instruments,narrative and feedback:A framework of behavioral public policy[J].Chinese Public Administration,(5):71-78.(in Chinese) 胡宏伟,刘雨佳,张开然.2024.长期护理保险试点与失能老年人家庭照料安排---基于政策设计差异的检验[J].江西社会科学,44(9):162-174.Hu H W,Liu Y J,Zhang K R.2024.Pilot programs of long-term care insurance and family care arrangements for disabled elderly-testing based on differences in policy design[J].Jiangxi Social Sciences,44(9):162-174.(in Chinese) 凌文豪,郝一潼.2022.老年人对政府养老责任的认知及影响因素研究---基于中国综合社会调查的实证分析[J].社会保障研究,(1):14-25.Ling W H,Hao Y T.2022.Research on the cognition of the elderly on the government's eldercare responsibility and its influencing factors-empirical analysis based on China general social survey[J].Social Security Studies,(1):14-25.(in Chinese) 刘冲,沙学康,张妍.2022.交错双重差分:处理效应异质性与估计方法选择[J].数量经济技术经济研究,39(9):177-204.Liu C,Sha X K,Zhang Y.2022.Staggered difference-in-differences method:Heterogeneous treatment effects and choice of estimation[J].Journal of Quantitative&Technological Economics,39(9):177-204.(in Chinese) 陆杰华,谷俞辰.2024.社会网络对中青年群体养老责任认同的影响研究---基于CGSS2018年数据的检验[J].人口学刊,46(1):81-95.Lu J H,Gu Y C.2024.The impact of social network on the recognition of responsibility for elderly care among young and middle-aged people in China:Evidence from CGSS 2018data[J].Population Journal,46(1):81-95.(in Chinese) 陆杰华,王馨雨,张雁雯.2019.社会转型背景下不同代际队列的养老责任观念变化探究---来自2015年中国综合社会调查数据的验证[J].华中科技大学学报(社会科学版),33(2):105-115.Lu J H,Wang X Y,Zhang Y W.2019.Changing norms of eldercare responsibilities across generational cohorts in the context of Chinese social transformation-evidence from CGSS of 2015[J].Journal of Huazhong University of Science and Technology(Social Science Edition),33(2):105-115.(in Chinese) 马琦峰,孙可心,郝勇.2025.老年医疗护理服务试点的政策效应研究---兼论长护险、医养结合政策协同的影响[J].中国卫生政策研究,18(2):16-23.Ma Q F,Sun K X,Hao Y.2025.Research on the policy effects of elderly medical and nursing services pilots:Also discuss the influence of policy synergy[J].Chinese Journal of Health Policy,18(2):16-23.(in Chinese) 潘东阳,李玥.2024.长期护理保险信息“破壁”何以可能、何以可为[J].社会建设,11(4):34-50.Pan D Y,Li Y.2024.How to break down the information barriers of long-term care insurance[J].Social Construction,11(4):34-50.(in Chinese) 王培杰,彭雨馨,张友浪.2022.政策设计、政策认同和生育偏好---基于“独生子女”政策的反馈效应分析[J].公共行政评论,15(5):27-48,196-197.Wang P J,Peng Y X,Zhang Y L.2022.Policy design,policy support,and fertility preference:The feedback effects of China's“one-child”policy[J].Journal of Public Administration,15(5):27-48,196-197.(in Chinese) 吴炜.2024.谁来养老:养老福利态度的城乡差异[J].暨南学报(哲学社会科学版),46(3):132-147.Wu W.2024.Who will care for the elderly:Urban-rural differences in attitudes toward old-age welfare[J].Jinan Journal(Philosophy&Social Sciences),46(3):132-147.(in Chinese) 谢宇菲,封进.2022.长期护理保险缩小了失能老人健康差距吗?[J].保险研究,(10):19-33.Xie Y F,Feng J.2022.Has the long-term care insurance resolved disparities in health for disabled elderly Chinese?[J].Insurance Studies,(10):19-33.(in Chinese) 徐宏.2019.中国农村人口养老责任观念及影响因素研究---基于CGSS2015的实证分析[J].厦门大学学报(哲学社会科学版),69(3):138-146.Xu H.2019.Influencing factors of concept of pension responsibility for the rural population:An empirical study based on CGSS 2015[J].Journal of Xiamen University(Arts&Social Sciences),69(3):138-146.(in Chinese) 徐俊,风笑天.2012.独生子女家庭养老责任与风险研究[J].人口与发展,18(5):2-10.Xu J,Feng X T.2012.Research on responsibility and risk of old-age support of one-child family in China[J].Population and Development,18(5):2-10.(in Chinese) 闫金山.2019.家庭对青年养老责任分担态度的影响研究---基于4期CGSS调查数据[J].调研世界,(9):43-48.Yan J S.2019.The influence of family on the attitude towards youth's sharing obligations of supporting elderly parents-based on 4 CGSS survey data[J].The World of Survey and Research,(9):43-48.(in Chinese) 晏子.2018.倾向传统还是走向现代:性别意识与养老责任态度---基于中国、日本、韩国的比较研究[J].公共行政评论,11(6):112-136,212.Yan Z.2018.Prone to tradition or modernity:Gender ideology and eldercare responsibilities-comparative study of China,Japan and South Korea[J].Journal of Public Administration,11(6):112-136,212.(in Chinese) 杨团.2016.中国长期照护的政策选择[J].中国社会科学,(11):87-110,207.Yang T.2016.Policy options for long-term care in China[J].Social Sciences in China,(11):87-110,207.(in Chinese) 杨茜,段世江.2023.城乡老年人养老责任认知影响因素及变迁趋势---基于时期和队列视角分析[J].河北大学学报(哲学社会科学版),48(5):100-112.Yang X,Duan S J.2023.Influencing factors and changing trends of elderly people's cognition of elderly care responsibility in urban and rural areas-analysis based on period and cohort perspective[J].Journal of Hebei University(Philosophy and Social Science),48(5):100-112.(in Chinese) 臧其胜.2016.政策的肌肤:福利态度研究的国际前沿及其本土意义[J].公共行政评论,9(4):171-190,209-210.Zang Q S.2016.The skin of social policy:International frontier and local significance of welfare attitude research[J].Journal of Public Administration,9(4):171-190,209-210.(in Chinese) 翟文康,邱一鸣.2022.政策如何塑造政治?---政策反馈理论述评[J].中国行政管理,(3):39-49.Zhai W K,Qiu Y M.2022.How do policies shape politics?-The review on policy feedback theory[J].Chinese Public Administration,(3):39-49.(in Chinese) 张波.2018.中国谁来养老?---基于中国人养老责任认知及其影响因素分析[J].华中农业大学学报(社会科学版),(4):99-109,170-171.Zhang B.2018.Who will provide resources for the age in China?-Cognition on Chinese's old-age insurance responsibility and its influencing factors[J].Journal of Huazhong Agricultural University(Social Sciences Edition),(4):99-109,170-171.(in Chinese) 张航空,马琦峰.2024.医疗保险会引致道德风险吗?---以城乡居民医保为例[J].中国卫生政策研究,17(10):9-16.Zhang H K,Ma Q F.2024.Does medical insurance cause moral hazard:Take medical insurance for urban and rural residents as an example[J].Chinese Journal of Health Policy,17(10):9-16.(in Chinese) 张友浪,王培杰.2023.公共政策反馈如何影响政府机构变迁?---基于生育政策的历史追踪分析(1949-2021)[J].上海行政学院学报,24(1):74-88.Zhang Y L,Wang P J.2023.How do policy feedback effects shape institutional reforms in China's public policy process?A historical tracking analysis based on the fertility policy(1949-2021)[J].The Journal of Shanghai Administration Institute,24(1):74-88.(in Chinese) 张云亮,柳建坤.2022.隔代照料对老年人身心健康的影响及机制分析---基于中国老年社会追踪调查2014年数据的实证分析[J].农业技术经济,(4):117-131.Zhang Y L,Liu J K.2022.The effect of intergenerational care on elderly's physical and mental health and its mechanism analysis:An empirical analysis based on 2014 data from the China longitudinal aging social survey[J].Journal of Agrotechnical Economics,(4):117-131.(in Chinese) 张争艳,王化波.2016.珠海市老年人口养老意愿及影响因素分析[J].人口学刊,38(1):88-94.Zhang Z Y,Wang H B.2016.Analysis of the desire on old-age support and its affecting factor in Zhuhai City[J].Population Journal,38(1):88-94.(in Chinese) 郑思齐,万广华,孙伟增,等.2013.公众诉求与城市环境治理[J].管理世界,29(6):72-84.Zheng S Q,Wan G H,Sun W Z,et al.2013.Public demands and urban environmental governance[J].Journal of Management World,29(6):72-84.(in Chinese) 朱铭来,何敏.2021.长期护理保险会挤出家庭照护吗?---基于2011-2018年CHARLS数据的实证分析[J].保险研究,(12):21-38.Zhu M L,He M.2021.Does long-term care insurance crowd out informal care?-Evidences from 2011-2018 CHARLS data[J].Insurance Studies,(12):21-38.(in Chinese) 朱铭来,康琢.2024.长期护理保险能够缓解健康不平等吗?---来自CHARLS数据的证据[J].保险研究,(4):90-100.Zhu M L,Kang Z.2024.Can long-term care insurance alleviate health inequality?-Evidences from CHARLS[J].Insurance Studies,(4):90-100.(in Chinese) 朱震宇.2023.长期护理保险对老年家庭照料的影响[J].中国人口科学,37(3):97-114.Zhu Z Y.2023.The effect of the long-term care insurance on family care for the elderly[J].Chinese Journal of Population Science,37(3):97-114.(in Chinese) Béland D,Campbell A L,Weaver R K.2022.Policy feedback:How policies shape politics[M].Cambridge:Cambridge University Press. Borusyak K,Jaravel X,Spiess J.2024.Revisiting event-study designs:Robust and efficient estimation[J].Review of Economic Studies,91(6):3253-3285. Campbell A L.2012.Policy makes mass politics[J].Annual Review of Political Science,15(1):333-351. Chen H,Ning J.2022.Public long-term care insurance scheme and informal care use among community-dwelling older adults in China[J].Health&Social Care in the Community,30(6):e6386-e6395. Chin C W W,Phua K H.2016.Long-term care policy:Singapore's experience[J].Journal of Aging&Social Policy,28(2):113-129. Dave D,Kaestner R.2009.Health insurance and ex ante moral hazard:Evidence from Medicare[J].International Journal of Health Care Finance and Economics,9(4):367-390. Goodman-Bacon A.2021.Difference-in-differences with variation in treatment timing[J].Journal of Econometrics,225(2):254-277. Guadalupe M,Kuzmina O,Thomas C.2012.Innovation and foreign ownership[J].American Economic Review,102(7):3594-3627. Haeder S F.2026.What information elicits policy enthusiasm?Older Americans,the ACA,and Medicare[J].Journal of Health Politics,Policy and Law,51(1):1-43. He A J,Ratigan K,Qian J W.2021.Attitudinal feedback towards sub-national social policy:comparison of popular support for social health insurance in urban China[J].Journal of Comparative Policy Analysis:Research and Practice,23(3):350-371. Jacobs L R,Mettler S,Zhu L.2022.The pathways of policy feedback:How health reform influences political efficacy and participation[J].Policy Studies Journal,50(3):483-506. Lei X Y,Bai C,Hong J P,et al.2022.Long-term care insurance and the well-being of older adults and their families:Evidence from China[J].Social Science&Medicine,296:114745. LüX B.2014.Social policy and regime legitimacy:The effects of education reform in China[J].American Political Science Review,108(2):423-437. Ma Q F,Ning J,Chen H.2025.Changes of filial responsibility norms under public long-term care insurance in China[J].Geriatrics&Gerontology International,25(4):606-619. Mettler S.2002.Bringing the state back into civic engagement:Policy feedback effects of the G.I.bill for World War II veterans[J].American Political Science Review,96(2):351-365. Mettler S.2011.The submerged state:How invisible government policies undermine American democracy[M].Chicago:University of Chicago Press. Pierson P.1993.When effect becomes cause:Policy feedback and political change[J].World Politics,45(4):595-628. Starr P.2013.Remedy and reaction:The peculiar American struggle over health care reform[M].New Haven:Yale University Press. Tsutsui T,Muramatsu N,Higashino S.2014.Changes in perceived filial obligation norms among coresident family caregivers in Japan[J].The Gerontologist,54(5):797-807. Villalobos Dintrans P.2020.Designing long-term care systems:Elements to consider[J].Journal of Aging&Social Policy,32(1):83-99. Wang H B,Gong X,Zhang K R.2026.How does social insurance policy affect citizens'political participation?An empirical research based on policy feedback theory[J].Review of Policy Research,43(1):e70012. Wang P J,Zhang Y L.2025.Cross-domain policy feedback effects on mass publics[J].Governance,38(2):e12905. Zhao L T,Qian J W,Shan W.2021.Filial piety,pension policy and changing perceptions of elderly care responsibility:Evidence from China[J].China:An International Journal,19(3):112-131.
• (1)相关数据来自国家统计局发布的《中华人民共和国2025年国民经济和社会发展统计公报》。 (2)人民网:《习近平强调推动老龄事业全面协调可持续发展》,2016年5月29日,https://jhsjk.people.cn/article/28387539,2026年7月17日访问。 (3)相关数据来自国家医保局发布的《2025年医疗保障事业发展统计快报》。 (4)本文估计长护险的意向处理效应主要因为:区别于长护险在健康、经济维度上的直接影响,长护险对老年人养老责任偏好的文化影响具有更强的政策溢出效应,即这类影响不只限于试点城市那些切实享受待遇保障的失能老人,还会同步影响试点城市中活力老人的养老预期,作用于其养老责任偏好。 (5)鉴于不同来源的家庭照料具有一定替代性,故对于多子女家庭而言,本文主要选取家庭照料频率最高的子女来反映受访者的非正式照护获取情况。 (6)省级官方报纸报道数据来自中国知网-中国重要报纸全文数据库、慧科新闻搜索研究数据库及《大众日报》(山东省)、《安徽日报》(安徽省)官方公众号,名单参见https://www.toutiao.com/article/7471167022132150825/,检索主题及关键词包括“长期护理保险”“长护险”“护理保险”“长期照护”“失能照护”;省级网络检索指数数据通过“省级行政单位名称+长护险主题”的PC端精确检索结果获得。 (7)本文实证分析部分使用的均为半径匹配后的数据,历年的三种匹配方法均通过了样本平衡性检验,限于篇幅,正文未展示相关结果。