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Prediction of the Number of and Care Costs for Disabled Elderly from 2020 to 2050: A Comparison between Urban and Rural Areas in China

by Liangwen Zhang 1,2,3, Sijia Fu 1,2 and Ya Fang 1,2,*
1
State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
2
Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen 361102, China
3
School of Economics, Xiamen University, Xiamen 361006, China
*
Author to whom correspondence should be addressed.
Sustainability 2020, 12(7), 2598; https://doi.org/10.3390/su12072598
Received: 22 February 2020 / Revised: 11 March 2020 / Accepted: 24 March 2020 / Published: 25 March 2020
(This article belongs to the Special Issue Sustainability of Fiscal Policy)
An aging population and an increase in the proportion of elderly people who are disabled have created an unprecedented global challenge, especially in China. This study aimed to predict the number of, and the care costs for, disabled elderly from 2020 to 2050 in China. A comparison was made between urban and rural areas, and we analyzed what must be done to maintain the sustainable development of China’s long-term care insurance (LTCI) system. An overall simulation model and a Monte Carlo simulation were used to estimate the number of disabled elderly and their related care costs, in both urban and rural areas. According to the forecast, the total disabled population will increase rapidly, rising from 43.75 million in 2020 to 91.4 million in 2050. Of that total, 69.7% are expected to be urban elderly. Starting in 2020, the growth rates of the elderly with mild, moderate, and severe disabilities will be 108%, 104%, and 120%, respectively, by 2050. Accordingly, the total care costs will increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050, of which 80.2% will be required in urban areas. In addition, the per capita costs of care in urban and rural areas in 2050 will be 6 times and 11 times higher than in 2020, respectively. The predicted results show that the number of disabled elderly and the related care costs will increase sharply from 2020 to 2050, especially the growth rate of the number of severely disabled elderly. This study provides strong evidence of the need for the establishment of a unified national LTCI system in China. View Full-Text
Keywords: urban and rural areas; elderly; disability scale; care cost; prediction urban and rural areas; elderly; disability scale; care cost; prediction
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Zhang, L.; Fu, S.; Fang, Y. Prediction of the Number of and Care Costs for Disabled Elderly from 2020 to 2050: A Comparison between Urban and Rural Areas in China. Sustainability 2020, 12, 2598.

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