What is the current state of aged care in China?

Answer from top 10 papers

The aging population in China presents a complex challenge, with a significant increase in the number of individuals aged 65 and above, necessitating the development of integrated medical and elderly care services (Qin et al., 2023). Despite the establishment of various service models and the promotion of home/community-based care, there are persistent issues such as service supply-demand mismatch, limited financing, and a shortage of specialized professionals (Qin et al., 2023). Additionally, the acceptance of home/community-based services is influenced by factors such as satisfaction with local medical services, urban residency, health insurance, and the presence of chronic diseases (Jia & Wang, 2017).
Interestingly, while spouses are the primary caregivers, this role often comes at the cost of their own health, with negative effects such as depression and hypertension, particularly among female caregivers (Xiao, 2023). Moreover, the adoption of smart elderly care services and products is not widespread, hindered by a lack of understanding and willingness among the elderly (Hung, 2022). The demand for elderly care services is rising, with significant regional disparities influenced by economic development, healthcare provision, and educational attainment (Bian et al., 2023). The traditional elderly care model is increasingly seen as unsustainable, prompting the government to implement smart elderly care services (Liu et al., 2024).
Community-based services are deemed most appropriate for the aging population, but improvements in laws, insurance systems, and service quality are needed (Zhou, 2019). The State Council's action plan for smart and healthy elderly care indicates a move towards informationalisation and digitalisation, though barriers to massification remain (Huang, 2023). The government is also exploring Public-Private Partnerships to optimize financing for elderly care services (Zhang, 2023). Lastly, home- and community-based elderly care systems have been shown to significantly enhance life satisfaction among the elderly, especially for certain demographic groups (Ai et al., 2022).
In summary, China's approach to aged care is multifaceted, involving integrated services, smart technology, and community-based solutions. While progress has been made, challenges such as financing, professional shortages, and uneven service acceptance and provision persist. Addressing these issues is crucial for improving the well-being of China's elderly population (Ai et al., 2022; Bian et al., 2023; Huang, 2023; Hung, 2022; Jia & Wang, 2017; Liu et al., 2024; Qin et al., 2023; Xiao, 2023; Zhang, 2023; Zhou, 2019).

Source Papers

Home/Community-Based Medical and Elderly Care Services Utilization in China: A Cross-Sectional Study from the Middle-Aged and Elderly Population.

Few studies have analyzed the acceptance of home/community-based medical and elderly care services in China. Therefore, we conducted a cross-sectional study to describe the acceptance of five services among people aged ≥ 45 years in the China mainland, and their influencing factors. The data were obtained from the database China Health and Retirement Longitudinal Study 2018. For each service, a binary logistics regression was adopted. A total of 9719 people were included, of whom 20.12% received services. The numbers of recipients (acceptance rates) of the five services, namely, comprehensive aged care services, regular physical examinations, onsite visits, health management, and entertainment, were 107 (1.10%), 1640 (16.87%), 323 (3.32%), 156 (1.61%), and 245 (2.52%), respectively. About 4% of people had received two or more services. The elderly aged 65-74 and those who were satisfied with the local medical services had higher acceptance of services. Urban hukou having health insurance, two or more chronic diseases, provincial economic welfare, and social welfare were positively associated with the acceptance of regular physical examination services. It is suggested that the government should gradually improve satisfaction with local medical services, and pay more attention to the needs of elderly people aged 65-74 for all kinds of home/community-based medical and elderly care services.

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Open Access
Smart Elderly Care Services in China: Challenges, Progress, and Policy Development

In 2017, the State Council of China published an action plan for the construction of a smart and healthy elderly care industry (2017–2020). The action plan designed and implemented by the State Council of China demonstrates the Central Government’s determination to informationalise and digitalise the Chinese society. Therefore, the market of smart home care services should expectedly mushroom in the coming decades, as the demand for smart home care increase. However, there are a range of barriers to achieving the massification of smart home care services, which will be discussed in the following sections. In addition to the shortage of family care and nursing services, elders being physically and psychologically vulnerable also engenders the Central Government to accelerate the provision of smart home care services to the Chinese elderly population. Here, smart home investment and delivery are necessary when building a sustainable elderly care system. The investment in smart home elderly care can lessen the long-term burden on China’s healthcare system as more elders would be able to self-manage their everyday life and minor physical and psychological problems. In this article, the author would critically analyses China’s implementation of smart home elderly care services, particularly on the benefits and challenges of technological advancement in elderly care and the advantages and problems of relevant policy development. The author also highlights how the informationalisation and digitalisation in elderly care and policy development enhance the convenience of the elderly populations’ everyday life when family care is limited or absent. Additionally, the author assesses what the gaps are in existing smart home elderly care technologies and policy development that need to be addressed by Chinese policymakers to further advance the safety and convenience of the elderly cohorts’ living.

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Open Access
Spatio-temporal Analysis of Demand for Elderly Care Services and Its Key Influencing Factors in Chinese Cities: A Web Search Engine Approach.

The demand for elderly care services (DECS) in Chinese Cities is one of the most concerned issues. The aim of this study was to understand the spatial and temporal evolution and external factors of DECS in Chinese cities and support the formulation of elderly care policies. We collected Baidu Index data for 287 prefecture-level and above cities and 31 provinces in China from January 1, 2012 to December 31, 2020. The Thiel Index was employed to describe the differences of DECS at different regional levels, and multiple linear regression was used to explore the external factors affecting DECS by calculating the variance inflation factor (VIF) to identify multicollinearity. The DECS of Chinese cities increased from 0.48 million in 2012 to 0.96 million in 2020, and the Thiel Index decreased from 0.5237 in 2012 to 0.2211 in 2020. Per capital GDP, number of primary beds, proportion of population aged 65 and over, number of primary care visits, and proportion of illiterate population over the age of 15 have significant influences on DECS (P < .05). DECS was on the rise in Chinese cities, with significant regional differences. At the provincial level, regional differences were influenced by level of economic development, primary care provision, aging population, educational attainment, and health status. It is suggested to pay more attention to DECS in small and medium-sized cities or regions, to strengthen primary care, and to improve the health literacy and health status of the elderly population.

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Open Access