Public trust in the long-term care insurance pilot program in China: An analysis of mediating effects

Objective: This study aimed to evaluate the implementation of the long-term care insurance (LTCI) pilot program in China through an examination of public trust in the system and its associated factors of insurance awareness and satisfaction with the LTCI policy. Method: An online survey was used to collect data from 786 participants in the city of Guangzhou, one of the pilot sites of the LTCI. Ordinal logistic regression models were used to investigate the related factors of public trust in the LTCI. Structural equation modeling (SEM) was conducted to test the mediating effect of satisfaction with LTCI policy on the relationship between insurance awareness and public trust. Results: More than 60% of participants gave a positive evaluation of the LTCI pilot program. More than 70% of the participants recognized the important role of the program. Both an understanding of insurance and satisfaction with LTCI policies were associated with public trust. The proportion of the indirect effect with regard to the total effect of satisfaction on trust was 70.133%, greater than the direct effect of 29.867%. Conclusions: Our findings supported the hypothesis that satisfaction with the LTCI policy plays a mediating role between insurance awareness and public trust. Optimalization of the LTCI policy was recommended to improve public trust in the LTCI program.