The CPC Seminar Series takes place between October and June, all seminars are free to attend and no registration is required. If you would like to present please contact

Long Term Care for older people in China: Need, cost and policy design

19th May 2016 3pm, University of Southampton 02/1039 (L/T K)

Xiaoting Liu, Zhejiang University

A joint CPC and CRA seminar: China is ageing very rapidly, and by mid-century, it will have 'caught up' with many countries in the developed world with respect to population ageing. Long term care (LTC) policy development, therefore, is becoming a priority in China, although it is still in its infancy. This seminar provides an integrated framework of need-and-cost analysis on the basis of ADLs/IADLs disability prevalence and its trends, before putting forward a budget proposal for a public, means-tested system of LTC provision. The dynamics of disability and related social determinants were investigated using three waves of nationally representative longitudinal data (SSAPUR, 2000, 2006 and 2010), applying a Random Effect model and a Generalized Estimating Equation model. Healthy life expectancy was estimated by the Sullivan method. The results indicated that the disability prevalence declined as life expectancy and disability-free life expectancy increased, and the duration of disability changed from compression to expansion. The number of disabled older people in need of LTC was estimated taking key social determinants into account (e.g. socio-economic status, urbanization, health insurance, health-risk behaviours). Results indicate that about 44 million people aged 60 and over (and 27 million persons aged 80+) would be in need of long term care in 2050. Against the background of a critical policy debate on whether to initiate LTC insurance in China, this research proposes a safety net public subsidy policy for the provision of LTC services both for today and into the future. As part of the government's responsibility, this subsidy policy is more realistic currently, and benefits vulnerable older groups. Using projections in several scenarios, the total LTC cost is projected to be only 0.25% of GDP to begin with (equivalent to about 1.25% of fiscal revenues), and will constitute about 1.42% of GDP in 2050, which is in line with the current average LTC expenditures among OECD countries (1.6% of GDP).

Download Presentation File 1 (pdf format)