背景:预测强度,来源,在强调孝道的东亚传统文化背景下,中国老年人非正式护理的成本对于建立和加强非正式护理的政策支持系统至关重要。本研究旨在分析2020-2040年中国老年人非正式护理需求的现状及影响因素,并预测其趋势。
方法:本研究利用2015-2018年CHARLS数据库,首先结合两部分模型和多项logit分析了中国城乡老年人非正式护理需求的影响因素。其次,构建了一个多状态马尔可夫模型来预测从2020年到2040年每个健康状态的城乡老年人口数量。最后,基于微观仿真模型,这项研究预测了非正式护理强度的趋势,来源,以及2020年至2040年城乡老年人的成本。
结果:2040年,中国残疾老年人口规模将进一步扩大。在农村地区,2040年残疾人总数(3977万人)比2020年增加1.50倍;城市、2040年残疾人总数(5601万人)比2020年增长2.51倍。与2020年相比,老年人口轻度,2040年中度和重度残疾将增加87.60%,101.70%,和115.08%,分别。2040年,老年人接受低,medium-,中国的高强度护理将达到3860万,2289万,和4169万,分别,老年人仍将依赖配偶和子女提供的非正式护理(仅来自配偶:3926万,仅限儿童:3674万,仅来自配偶和子女:1679万,其他:1039万)。2040年的非正式护理总费用为18866.5亿元,是2020年的2.22倍(4903.1亿元),增长速度快于经济增长速度。
结论:从2020年到2040年,由于人口结构和快速城市化,农村地区老年人的非正式护理需求将先增加后减少。相比之下,从2020年到2040年,城市老年人的非正式护理需求将不断增加,增长速度将逐渐放缓。本研究为科学衡量非正式护理的经济价值和合理分配护理资源提供了循证依据。
BACKGROUND: Forecasting the intensity, source, and cost of informal care for older adults in China is essential to establish and enhance policy support systems for informal care within the context of East Asian traditional culture that emphasizes filial piety. This study aims to analyze the current situation and influencing factors for the informal care needs and predict the trends of informal care needs for older adults in China from 2020 to 2040.
METHODS: Using the CHARLS database from 2015 to 2018, this study first combined a two-part model and a multinomial logit to analyze the influencing factors for the informal care needs of urban-rural older adults in China. Secondly, a multi-state Markov model was constructed to forecast the number of urban-rural older populations in each health state from 2020 to 2040. Finally, based on a microsimulation model, this study predicted the trends of informal care intensity, source, and cost for older adults in urban and rural areas from 2020 to 2040.
RESULTS: In 2040, the size of the disabled older population in China will expand further. In rural areas, the total number of disabled people in 2040 (39.77 million) is 1.50 times higher than that in 2020; In urban areas, the total number of disabled people in 2040 (56.01 million) is 2.51 times higher than that in 2020. Compared with 2020, older adults population with mild, moderate and severe disability in 2040 would increase by 87.60%, 101.70%, and 115.08%, respectively. In 2040, the number of older adults receiving low-, medium-, and high-intensity care in China will be 38.60 million, 22.89 million, and 41.69 million, respectively, and older people will still rely on informal care provided by spouses and children (from spouses only: 39.26 million, from children only: 36.74 million, from spouses and children only: 16.79 million, other: 10.39 million). The total cost of informal care in 2040 will be 1,086.65 billion yuan, 2.22 times that of 2020 (490.31 billion yuan), which grows faster than the economic growth rate.
CONCLUSIONS: From 2020 to 2040, the informal care needs of older people in rural areas will increase first and then decrease due to the demographic structure and rapid urbanization. In contrast, the informal care needs of older people in urban areas will continuously increase from 2020 to 2040, with the growth rate gradually slowing down. This study provides an evidence-based rationale for scientifically measuring the economic value of informal care and reasonably allocating care resources.