Research on Evaluation and Optimization of Long-Term Care Insurance Pilot Policies: Based on Multidimensional Quantitative Analysis of Policy Texts and Satisfaction Survey of Disabled OlderAdults

Exploring the establishment of a Long-Term Care Insurance (LTCI) system represents a crucial strategy for addressing population aging and enhancing the social security framework. Using Shandong Province as a case study, this paper measures and evaluates its LTCI pilot policies. First, we analyze policy texts issued by all 16 pilot cities in Shandong. Selecting 10 key variables (including coverage scope, benefit range, fund financing, and benefit payment), we construct a policy evaluation index system. Then the AHP-EWM coupling algorithm is employed to calculate hierarchical index weights and derive comprehensive policy effectiveness scores for each city. Results indicate that within the index system, benefit payment levels, claims processing/reimbursement management, and service management exert the most significant influence on policy effectiveness. The average policy effectiveness score across pilot cities is 73.97 (out of 100), revealing substantial inter-city disparities. Subsequently, based on a satisfaction survey of disabled older adults, we found an overall high satisfaction level with LTCI (80.26 out of 100). However, areas identified for improvement include the assessment process, benefit evaluation criteria, and service duration. Empirical analysis using a Multi-Indicator Multi-Cause (MIMIC) structural equation model demonstrates that beneficiaries' overall satisfaction is influenced by individual characteristics, LTCI participation and benefits received, geographic location, and other factors. Specifically, higher satisfaction with the LTCI system is associated with being male, younger age, lower education levels, and greater economic independence. These findings provide evidence-based recommendations for improving and optimizing the nationwide implementation of the LTCIsystem.