摘要目的:分析长期照护保险对失能老年人跌倒发生率的影响，以及不同居住方式的效应修饰作用。方法:基于2014年7月至2021年6月成都市申请长期照护保险的城镇居民住院记录中的出院诊断记录，以得到长期照护险覆盖者为干预组，未覆盖者为对照组，使用双重差分法分析长期照护保险实施前后跌倒发生率的变化，并采用分层分析探索不同居住方式的效应修饰作用。结果:长期照护保险的覆盖显著降低了老年人每月跌倒发生率［干预者平均处理效应（ATT）=-1.21%（95% CI：-1.82%~-0.60%）］，且效果随时间的增加而增加［ATT=-1.26%（95% CI：-1.93%~-0.59%）］。长期照护保险对与配偶/亲属居住［ATT=-0.92%（95% CI：-1.47%~-0.37%）］以及居住在养老机构/医院［ATT=-2.10%（95% CI：-3.81%~-0.40%）］的老年人有显著影响，在独居人群中效应不显著。 结论:长期照护保险能有效降低老年人的跌倒发生率，对失能老年人有积极影响，与家人居住或在养老机构/医院居住对长期照护保险政策实施效果有效应修饰作用，后期应关注重点人群，扩大长期照护保险的覆盖范围。

abstractsObjective:To analyze the effect of long-term care insurance on the incidence of falls in old people with disability, and the modification effect of different living arrangements.Methods:Based on the discharge diagnosis records of the hospitalization in urban residents who applied for long-term care insurance in Chengdu from July 2014 to June 2021, those who received long-term care insurance were selected as the intervention group and those who received no long-term care insurance were selected as the control group, the changes in the incidence of falls before and after the long-term care were analyzed using difference-in-differences method, and the modification effects of different living arrangements were explored using stratified analysis.Results:Long-term care insurance significantly reduced the risk for monthly incidence of falls in older adults [average treatment effects on treated (ATT) = -1.21% (95% CI: -1.82%--0.60%)], and the effect increased over time (ATT=-1.26%, 95% CI: -1.93%--0.59%). Long-term care insurance had a significant effect on reducing the incidence of falls in old people living with spouses/family members (ATT=-0.92%, 95% CI: -1.47%--0.37%) and in nursing facilities/hospitals (ATT=-2.10%, 95% CI: -3.81%--0.40%), but it had no significant effect in those living alone. Conclusions:Long-term care insurance can effectively reduce the incidence of falls in old people with disability, showing a positive effect. Living with family members or in nursing facilities/hospitals has a modification effect of the implementation of long-term care insurance policy. It is necessary to pay attention to key populations in the future and expand the coverage of long-term care insurance.