The Impact of Integrated Medical and Nursing Care on Elderly Health: Mechanisms and Empirical Evidence

To meet the demand for high-quality health and elderly care, integrated medical and nursing care has become an inevitable trend. China has launched two batches of national pilot programs for integrated medical and nursing care, initially exploring a model suited to the national context. However, there is currently a lack of systematic evaluations with policy implications, primarily due to the unclear theoretical mechanisms and specific pathways through which integrated care affects the health of the elderly. This paper utilizes nationally representative longitudinal survey data of the elderly to explore the impact of integrated medical and nursing care policies on the health of the elderly from both theoretical and empirical perspectives. Estimates from a difference-in-differences model indicate that the implementation of integrated care policies significantly improves the physical and mental health of the elderly, covering key indicators such as self-rated health, depression risk, and social adaptability. Mechanism analysis reveals that integrated care policies not only provide higher quality and more convenient medical and nursing services for the elderly but also enhance social cohesion on multiple levels. On one hand, integrated care optimizes the allocation of social capital, creating a more friendly living environment for the elderly; on the other hand, the implementation of these policies strengthens the social atmosphere of respecting, loving, and assisting the elderly, significantly enhancing their sense of belonging to their living areas, thereby promoting their psychological well-being. Additionally, integrated care improves the social networks of the elderly, expanding their social interaction scope and providing more emotional support and psychological comfort. Heterogeneity analysis shows that integrated care policies have a more pronounced effect on improving the health of elderly women and those with higher socioeconomic status. At the urban-rural level, the policy effects do not show significant differences, but at the household registration level, the health improvement of local elderly residents is significantly higher than that of non-local residents. From a regional perspective, the policy effects are greater in economically developed areas with richer medical resources. This reflects the current inadequacies in the equity of integrated care services. The findings of this study have important practical implications for comprehensively evaluating the effects of integrated care policies and optimizing the existing operational models of integrated care.