Abstract
An aging population and an increase in the proportion of elderly people who are disabled have created an unprecedented global challenge, especially in China. This study aimed to predict the number of, and the care costs for, disabled elderly from 2020 to 2050 in China. A comparison was made between urban and rural areas, and we analyzed what must be done to maintain the sustainable development of China’s long-term care insurance (LTCI) system. An overall simulation model and a Monte Carlo simulation were used to estimate the number of disabled elderly and their related care costs, in both urban and rural areas. According to the forecast, the total disabled population will increase rapidly, rising from 43.75 million in 2020 to 91.4 million in 2050. Of that total, 69.7% are expected to be urban elderly. Starting in 2020, the growth rates of the elderly with mild, moderate, and severe disabilities will be 108%, 104%, and 120%, respectively, by 2050. Accordingly, the total care costs will increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050, of which 80.2% will be required in urban areas. In addition, the per capita costs of care in urban and rural areas in 2050 will be 6 times and 11 times higher than in 2020, respectively. The predicted results show that the number of disabled elderly and the related care costs will increase sharply from 2020 to 2050, especially the growth rate of the number of severely disabled elderly. This study provides strong evidence of the need for the establishment of a unified national LTCI system in China.
Highlights
China is a developing country with the largest population in the world [1]
Similar to the prediction results in previous studies [21], the predicted results in this study showed that the number of disabled elderly will increase in both urban and rural areas, and community home-based care will continue to be the mainstream type of long-term care (LTC)
The predicted results showed that the number and care costs of disabled elderly will increase sharply from 2020 to 2050
Summary
China is a developing country with the largest population in the world [1]. According to the National Bureau of Statistics of China, 249 million people were aged over 60 years at the end of 2018 in China, accounting for 17.9% of the total population [2]. It is believed that an aging population will significantly increase the need for long-term care (LTC) and will require more public expenditure due to increasing disability trends [4,5]. The LTC of the disabled elderly places an economic and care burden on individuals and their families. This has become a common risk faced by society; elderly care presents a significant challenge to the social insurance system. Predicting how the demand and costs of LTC will grow in the future is of great significance, if China is to meet the care needs of its disabled elderly and establish a unified national long-term care insurance (LTCI) system
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