System Simulation and Policy Response: Long-Term Care Needs of the Elderly with Disabilities in China (2021-2050)

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".

Needs and influence factors of medical-nursing-pension of disabled elderly

“…Age, educational level, monthly income, economic source, time spent disabled, living with children, and participation in medical insurance are all influencing factors on disabled elderly’s demand for medical-nursing-pension. The elderly with advanced age, low educational level, low monthly income, economic source of pension from own, long period of disabled living, no children, and nonparticipation in medical insurance should be provided with additional medical assistants and health education by community nurses, the community medical doctors and nurses could provide more personalized home visit services in medical-nursing-pension for disabled elderly, including health education on oxygen inhalation, wound dressing, dietary, living, the prevention of disease, and health consultation, while the relevant departments should improve relevant policy [ 21 , 22 ] to adapt to the demand for medical-nursing-pension for disabled elderly in the community.…”

Integrating familial care and extra‐familial care into a new long‐term care policy for China: Examples from Germany's long‐term care insurance

“…The instrument classifies older persons' care needs and determines their eligibility based on a scoring system that tests for impairments in ADL and cognitive (e.g., memory, orientation) and sensory abilities (e.g., listening, speaking, understanding; Chinese State Council, 2021). However, it is restricted to persons with severe physical care needs (Wang et al, 2018; Zhu & Österle, 2019), with little emphasis on impairments in intellectual and psychological capabilities (Ma & Yang, 2021). Moreover, the LTC policy does not entail further restrictions to access, such as means‐testing.…”

“…The main reason for this strict targeting is that the current LTC system lacks an independent funding basis, such as individual contributions or tax funding, and mainly relies on co‐funding from the healthcare and social‐assistance system (Ma & Yang, 2021; Zhu & Österle, 2019; Zhu & Walker, 2021).…”

“…• Public support for extra-familial and family care should be an effective approach to the Chinese LTC policy. (Wang et al, 2018;Zhu & Österle, 2019), with little emphasis on impairments in intellectual and psychological capabilities (Ma & Yang, 2021). Moreover, the LTC policy does not entail further restrictions to access, such as means-testing.…”

Enhancing the resilience of the power system to accommodate the construction of the new power system: key technologies and challenges

“…In July 2022, because of the continuous high temperature and dry weather, the electricity consumption of State Grid Sichuan increased by 19.79% year-onyear. However, the hydropower decreased from about 900 million kW hours in the same period to about 450 kWh, causing a shortage of power supply and limited usage (Ma and Wu, 2021).…”