Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Apr;27(3):519-50.
doi: 10.1177/0898264314552690. Epub 2014 Sep 10.

Implications of changes in households and living arrangements for future home-based care needs and costs for disabled elders in China

Yi Zeng  1 , Huashuai Chen  2 , Zhenglian Wang  3 , Kenneth C Land  3
Affiliations

Implications of changes in households and living arrangements for future home-based care needs and costs for disabled elders in China

Yi Zeng et al. J Aging Health. 2015 Apr.

Abstract

Objectives: To better understand future home-based care needs and costs for disabled elders in China.

Method: To further develop and apply the ProFamy extended cohort-component method and the most recent census and survey data.

Results: (a) Chinese disabled elders and the annual growth rate of the percentage of national gross domestic product (GDP) devoted to home-based care costs for disabled elders will increase much more rapidly than the growth of total elderly population; (b) home-based care needs and costs for disabled oldest-old aged 80+ will increase much faster than that for disabled young-old aged 65-79 after 2030; (c) disabled unmarried elders living alone and their home-based care costs increase substantially faster than those disabled unmarried elders living with children; (d) percent of rural disabled oldest-old will be substantially higher than that of rural population after 2030; (e) sensitivity analyses show that possible changes in mortality and elderly disability status are the major direct factors affecting home-based care needs and costs; (f) caregivers resources under the universal two-child policy will be substantially better than that under the rigorous fertility policy unchanged.

Discussion: We discuss policy recommendations concerning pathways to healthy aging with relatively reduced care costs, including reductions of the prevalence of disability, gender equality, the universal two-child policy and resources of caregivers, encouragements of rural-to-urban family migration and elder's residential proximity to their adult children, and remarriages of not-married elders.

Keywords: disability; elderly living arrangements; home-based care costs; household projection; population aging.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Basic theoretical and demographic framework of this study
Figure 2
Figure 2
Computational strategy to calculate changes in demographic, familial and ADL statuses of older adults by single year of age
Figure 3
Figure 3. Transition probabilities between ADL statuses for older adults, by rural/urban residence, gender, marital status, and coresidence with children
Note: The p values indicate the levels of statistical significance of the overall difference between the two curves under comparison, adjusted for ages and all other variables included in this figure as covariates in the multivariate regressions.
Figure 4
Figure 4. Annual home-based care costs in cash (yuan) per ADL disabled elder, by rural/urban residence, gender, marital status, and coresidence with children
Note: The same as in Figure 3.
Figure 5
Figure 5
Projected numbers of ADL disabled elders under different scenarios (in millions)
Figure 6
Figure 6
Projected numbers of home-based care work days for disabled elders delivered by family members under different scenarios (in billions)
Figure 7
Figure 7
Figure 7a. Projected percentages of total home-based care costs in cash for disabled elders among national GDP, service wages follow trend extrapolation Figure 7b. Projected percentages of total home-based care costs in cash for disabled elders among national GDP, service wages grow at same rate of GDP
Figure 8
Figure 8
Projected numbers of caregivers aged 18–64 under different fertility policies (unit: 100 millions)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bongaarts J. The projection of family composition over the life course with family status life tables. In: Bongaarts J, Burch T, Wachter KW, editors. Family demography: Methods and applications. Oxford, UK: Clarendon Press; 1987. pp. 189–212.
    1. Bongaarts J, Feeney G. On the Quantum and Tempo of Fertility. Population and Development Review. 1998;24(2):271–291.
    1. Burch TK. Comment on a comparison between headship-rate approach and the ProFamy method. Personal email communication. 1999.
    1. Chen H. Assessment of the quality of the cross-sectional data collected in the 2008 wave of Chinese Longitudinal Healthy Longevity Survey. In: Zeng Yi., editor. Research on Elderly Population, Family, Health and Care Needs/Costs (in Chinese) Beijing: Science Press; 2010. pp. 350–352.
    1. CMMS: Center for Medicare and Medicaid Services. Projections of National Health Expenditures: Methodology and Model Specification. Baltimore: the Centers for Medicare & Medicaid Services; 2004. http://www.cms.hhs.gov/statistics/nhe/projections-methodology/

Publication types