Prediction the Contribution Rate of Long-Term Care Insurance for the Aged in China Based on the Balance of Supply and Demand

There are a large number of disabled elderly people in China, which results in huge care and financial burdens to their families and society. However, China has not yet launched a unified long-term care insurance (LTCI) system. This study aims to predict the contribution rate of LTCI in China from 2020 to 2050 based on the long-term care (LTC) cost of the disabled elderly, aged 65 and over, in order to provide strong evidence for the establishment of a unified and sustainable national LTCI system in China. The simulations are based on data from the population census data, the Chinese statistical yearbook, and the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database. Based on the International Labor Organization (ILO) financing model from the perspective of fund balance, an overall simulation model and a Monte Carlo simulation are used to estimate the contribution rate of LTCI for disabled elderly from 2020 to 2050 in China. The total financial demands will increase sharply from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050. Of that total, 80.2% will be required in urban areas. In addition, the per capita financial demands of care in urban and rural areas in 2050 will be approximately six times and 11 times higher than in 2020, respectively. The predicted results show that the overall contribution rate of LTCI in China will increase sharply from 1.46% in 2020 to 5.14% in 2050, an increase of about 3.5 times. By comparison, the contribution rate in 2020 will be close to 1.33% in Japan in 2015 and 1.40% in Germany in 2010. According to the 1:1 payment proportion between employer and employee, each side bears 0.68% of the insurance premium. From 2020 to 2050, the financial demands of long-term care for disabled elderly in China will increase, especially in urban areas, and the burden of per capita financial demands in rural areas will increase significantly. The overall contribution rate of LTCI will increase linearly and the payment burden of policyholders will increase year by year. This study provides evidence of the need for the establishment of a sustainable financing mechanism for multiple financial supplies.

Download Full-text

Review of evolution of the public long-term care insurance (LTCI) system in different countries: influence and challenge

BMC Health Services Research ◽

10.1186/s12913-020-05878-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Linhong Chen ◽

Lu Zhang ◽

Xiaocang Xu

Keyword(s):

Long Term Care ◽

The Elderly ◽

Term Care ◽

The Public ◽

Disabled Elderly ◽

The Disabled ◽

Long Term Care Insurance ◽

The Relationship

Abstract Background The growing demand for LTC (Long-term care) services for disabled elderly has become a daunting task for countries worldwide, especially China, where population aging is particularly severe. According to CSY (China Statistical Yearbook,2019), the elderly aged 65 or above has reached 167 million in 2018, and the number of disabled elderly is as high as 54%. Germany and other countries have alleviated the crisis by promoting the public LTCI (Long-Term Care Insurance) system since the 1990s, while China’s public LTCI system formal pilot only started in 2016. Therefore, the development of the public LTCI system has gradually become a hot topic for scholars in various countries, including China. Methods This review has been systematically sorted the existing related literature to discuss the development of public LTCI (Long-Term Care Insurance)system form four aspects, namely, the comparison of public LTCI systems in different countries, the influence of public LTCI, challenge of public LTCI, and the relationship between public LTCI and private LTCI. We searched some databases including Web of Science Core Collection, Medline, SCOPUS, EBSCO, EMBASE, ProQuest and PubMed from January 2008 to September 2020. The quality of 38 quantitative and 21 qualitative articles was evaluated using the CASP(Critical Appraisal Skills Programme) critical evaluation checklist. Results The review systematically examines the development of public LTCI system from four aspects, namely, the comparison of public LTCI systems in different countries, the influence of public LTCI, the challenge of public LTCI, and the relationship between public LTCI and private LTCI. For example, LTCI has a positive effect on the health and life quality of the disabled elderly. However, the role of LTCI in alleviating the financial burden on families with the disabled elderly may be limited. Conclusion Some policy implications on the future development of China’s LTCI system can be obtained. For example, the government should fully consider the constraints such as price rise, the elderly disability rate, and the substantial economic burden. It also can strengthen the effective combination of public LTCI and private LTCI. It does not only help to expand the space for its theoretical research but also to learn the experiences in the practice of the LTCI system in various countries around the world. It will significantly help the smooth development and further promote the in-depth reform of the LTCI system in China.

Download Full-text

Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

Journal of Aging Research ◽

10.1155/2018/4180565 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Pattaraporn Khongboon ◽

Sathirakorn Pongpanich

Keyword(s):

Informal Care ◽

Rural Areas ◽

Urban Areas ◽

Socioeconomic Development ◽

Long Term Care ◽

The Elderly ◽

Term Care ◽

Rural And Urban Areas ◽

Rural And Urban

Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

Download Full-text

A Study of Long-term Care Insurance Services Usage by Home-bound Disabled Elderly

Rigakuryoho Kagaku ◽

10.1589/rika.29.731 ◽

2014 ◽

Vol 29 (5) ◽

pp. 731-734

Author(s):

Ryoma NAKAGOSHI ◽

Seiichi TAKEMASA ◽

Yoshifumi NANBA ◽

Hirofumi MORIOKA ◽

Masataka OYAMA ◽

...

Keyword(s):

Long Term Care ◽

Term Care ◽

Disabled Elderly ◽

Long Term Care Insurance

Download Full-text

Comparison of the Measurement of Long-Term Care Costs between China and Other Countries: A Systematic Review of the Last Decade

Healthcare ◽

10.3390/healthcare8020117 ◽

2020 ◽

Vol 8 (2) ◽

pp. 117 ◽

Cited By ~ 2

Author(s):

Qingjun Zeng ◽

Qingqing Wang ◽

Lu Zhang ◽

Xiaocang Xu

Keyword(s):

Systematic Review ◽

Long Term Care ◽

Academic Research ◽

Care Providers ◽

Term Care ◽

Disabled Elderly ◽

The Disabled ◽

Long Term Care Insurance ◽

Care Costs

Background: The rapid aging of populations in some countries has led to a growing number of the disabled elderly, creating a huge need for Long-Term Care (LTC) and meeting its costs, which is a heavy economic burden on the families of the disabled elderly and governments. Therefore, the measurement of Long-Term Care (LTC) costs has become an important basis for the government to formulate Long-Term Care (LTC) policies, and academic research on Long-Term Care (LTC) costs is also in the process of continuous development and deepening. Methods: This is a systematic review that aims to examine the evidence published in the last decade (2010–2019) regarding the comparison of the measurement of Long-Term Care (LTC) costs between China and other countries. Results: Eighteen Chinese studies and 17 other countries’ studies were included in this review. Most Chinese scholars estimated long-term care costs based on the degree of disability among the disabled elderly. However, the studies of European and American countries are more and more in-depth and comprehensive, and more detailed regarding the post-care cost of specific diseases, such as Parkinson’s disease, Alzheimer’s disease, and epilepsy. Conclusion: In future academic research, we should fully consider the human value of long-term care providers and further study the differences in the long-term care costs of different chronic diseases. In China’s future policymaking, according to the experience of Germany, Sweden, and other countries, it may be an effective way to develop private long-term care insurance and realize the effective complementarity between private long-term care insurance and public long-term care insurance (LTCI).

Download Full-text