Abstract: This paper conducts a quantitative analysis of the policy effects of China’s pilot reforms in home- and community-based eldercare services using panel data from the China Longitudinal Ageing Social Survey (CLASS) for 2014 and 2020 and a difference-in-differences (DID) model. An “individual-family” dual-effects model is built for this purpose. The aforementioned analysis reveals the following four results. First, the “mental health effects” of the pilot reforms were validated by the data from the pilot policies, yet primarily evident in female older people and urban elderly. Second, the pilot reforms showed quite high family spillover effects and notably inspired filial piety and relevant behaviors among children towards their older parents, which played an important role in promoting family development and the reconstruction of filial norms in the new era. Third, the pilot reforms expanded the social networks of older people, thus improving their mental health. Finally, although the core achievement of the pilot reforms lay in daily care services, they provided a path for the integrated development of medical care and health care with their extensive health assessments. Overall, these findings provide valuable insights for advancing the high-quality development of China’s home- and community-based service systems.

Keywords: Home- and Community-based Eldercare Services, Pilot Reforms, Policy Effects, “Individual-Family” Dual Effects Model

摘要： 通过构建“个体-家庭”双重效应模型，采用中国老年社会追踪调查(CLASS)2014年和2020年面板数据以及双重差分模型(DID)，对中国居家和社区养老服务改革试点的政策效应进行量化分析。研究发现，改革试点的“心理健康效应”得到政策试点数据验证，但主要体现在女性老年人和城镇老年人中；改革试点具有较高的家庭溢出效应，显著激发了子女的孝心孝行，对于促进新时期家庭发展和孝道重构具有重要作用；改革试点扩大了老年人社交网络，进一步改善了其心理健康；尽管改革试点的核心成就在于日常照料服务，但因其产生的大规模健康摸排为推进医养康养融合发展提供了路径。研究结果对于推进中国居家和社区养老服务体系高质量发展具有重要意义。

关键词: 居家和社区养老服务, 改革试点, 政策效应, “个体-家庭”双重效应模型