Abstract
Background: In the near future, pressures on long-term care (LTC) are expected to grow with demographic transition. Higher demand for formal services is emerging in China also because of people’s expectations for high-quality care. This study aims to provide quantitative estimates of the associated LTC financial liability in the medium to long run to 2050, and is expected to further facilitate policy design on national LTC systems, which begin to be formulated and debated. Methods: We first analyze the health status of Chinese elderly through the Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) in 2015, 2016 and 2017, the largest database of research on aging in China. Subsequently, we estimate LTC needs and the government’s financial burden for the next 3 decades according Qingdao model. Results: The average elderly disability rate is 4.4% in 2015-2017, and the gender differences (3.9% for males, 4.67% for females), disparities between rural and urban areas, age differences exist. The proportion of public expenditure on long-term care costs will increase from 0.35 percent in 2021 to 0.68 percent in 2050, and that of proportion in GDP will increase from 0.1 percent to 0.2 percent. Conclusions: Compared with OECD countries, China’s LTC system started late and developed relatively slowly. The “policy window” between 2021 and 2036 is critical for China in developing LTC policies. In the period of “gradually getting wealthy and quickly getting old”, policy-makers should give priority to achieve “healthy aging” instead of “survival aging”.
Highlights
The demographic structure of China is expected to change rapidly in the near future
The disability rate in rural areas increases from 3.9 percent to 4.8 percent, with a larger increase of 0.9 percent
The rate of the disabled elderly in urban areas rises from 4.1 percent to 4.7 percent, with a slight increase of 0.6 percent
Summary
The demographic structure of China is expected to change rapidly in the near future. Aging populations pose serious challenges for the health and long-term care systems around the world (Kinsella & He, 2009). The demand for long-term care services and its cost for the elderly are growing rapidly, catalyzed by government policies and private-sector initiatives (Xu et al, 2019; Zeng et al, 2019; Feng et al, 2012). Long-term care aims to relieve family care burden, which is one of the key measures to improve the survival quality of the elderly with disabilities. Long-term care is often unaffordable in the absence of social protection For this reason, countries have started exploring long-term care insurance (LTCI) systems. Accurate measurement of elderly disability and long-term care costs have gradually become important basis for formulating long-term care policies (Zeng et al, 2020). Pressures on long-term care (LTC) are expected to grow with demographic transition. In the period of “gradually getting wealthy and quickly getting old”, policy-makers should give priority to achieve “healthy aging” instead of “survival aging”
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