Long-Term Care Needs and Related Issues in China
Social Sciences in Health Care and Medicine, pp. 52-84, Janet B. Garner and Thelma C. Christiansen, eds., Nova Science Publishers, 2008
34 Pages Posted: 28 Dec 2012
Date Written: December 18, 2008
Long-term care is receiving increasing attention as population aging increases the demand for long-term care services and boosts the cost of health expenditures. Although China’s old age support system has been studied, previous research has insufficiently examined the long-term care system and its related issues.
This chapter systematically evaluates long-term care needs, costs, unmet needs, provisions, finances, and their associated factors among the Chinese elderly population. We mainly use the data from the 2005 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) including 15,593 elders aged 65 and older with over-sampling of the oldest-old to investigate these issues. Additional data were analyzed including a nationwide survey on the elderly and the 2000 census.
We find that about 5-6% (or about 5.7 million) of the Chinese elderly needed long-term care in 2005 if the long-term care need was defined as a status in which a person has been disabled in any of six of activities of daily living for more than ninety days. That figure will reach 27 million in 2050 given the same age-sex-specific prevalence rates. Yearly long-term care expenditures reached 21 billion Yuan in 2005, accounting for 2.7% of total health expenditures. The proportion of unmet and undermet needs was nearly 60%. In other words, there were 3.5 million Chinese elders who needed long-term care services but could not access them. This number could climb to 16 million in 2050 given the same age-sex-specific rate.
Our results revealed that more than 80% of long-term care services were provided by family and more than 50% of costs were paid for by family. Our results further revealed that care needs, costs, unmet and undermet needs, provisions, and sources of payments varied across regions and between urban and rural areas, and that individual socioeconomic status and family/social resources were associated with long-term care needs, provisions, and finances, although such associations did not follow the same patterns across subpopulations. These findings are useful in identifying target populations, assessing the long-term care needed, and initiating appropriate services given that rapid population aging and dramatic social and demographic changes will bring great pressure on and challenges to the long-term care system in China.
Keywords: China, the elderly, old age support, long-term care, long-term care cost, unmet need, human security, demographic security, population security, filial piety, health, mortality.
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