The availability and affordability of long-term care for disabled older people in China: The issues related to inequalities in social security benefits

Abstract

BackgroundChina is experiencing increasing pressure from issues relating to an ageing population. The rationality of different eligibility criteria of the benefits within the social security system has been widely challenged; however, to date, no previous study has explored its association with the availability and affordability of long-term care (LTC). AimThis study evaluates the availability and affordability of Long-Term Care (LTC) services for disabled older people (aged 65 and above) in China, with special attention to the differences among groups in receipt of specific social security benefits. MethodsThe data of availability and affordability of LTC services for disabled older people is from a nationally representative sample Chinese Longitudinal Healthy Longevity Survey (CLHLS). Three different social security benefits were identified and their effects on the long-term care services for disabled older people were explored. ResultsThe overall proportions of disabled older people who have only limited or no available or affordable LTC services were remarkably high, especially for those who have moderate or no social security benefits. Compared to those who are entitled to generous social security benefits, older people who have no social security benefits are 18.45 times more likely to be unable to afford health care expenses. ConclusionThe findings imply that policy makers in China could focus on the LTC needs for the social security and socioeconomically disadvantaged (who have limited or no social security benefits and in low household income) disabled older people which could reduce the gap between them and those who are entitled to generous social security benefits.