The Impact of Long-Term Care Policy on the Percentage of Older Adults With Disabilities Cared for by Family Members in China: A System Dynamics Simulation

Abstract

This study examined the impact of current and future long-term care (LTC) policies on the family caregiving burden in China. System dynamics (SD) methodology was used to construct an LTC delivery system model that simulates the demand of LTC, living options, and LTC service use for disabled older adults. The model was based on three policy variables including the proportion of payment from LTC insurance, the growth rate of beds in LTC institutions, and the time to adjusting the capacity of community-based care. Results showed that the percentage of older adults with disabilities cared for by family members was projected to increase from 92.6% in 2015 to 97.8% in 2035, assuming no policy changes; under the mixed policy scenario, this percentage would reduce significantly to 63.8% in 2035. These findings illustrate that changes in LTC policy and delivery system have a significant impact on family care.

Keywords

long-term care elder care policy family caregiving system dynamic model

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References

Alders

Costa-Font

de Klerk

Frank

(2015). What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands. Health Policy, 119(6), 814–820.

Ansah

J. P.

Eberlein

R. L.

Love

S. R.

Bautista

M. A.

Thompson

J. P.

Malhotra

Matchar

D. B.

(2014). Implications of long-term care capacity response policies for an aging population: A simulation analysis. Health Policy, 116(1), 105–113.

Ansah

J. P.

Matchar

D. B.

Love

S. R.

Malhotra

Y. K.

Chan

Eberlein

(2013). Simulating the impact of long-term care policy on family eldercare hours. Health Services Research, 48(2 Pt. 2), 773–791.

Barber

López-Valcárcel

B. G.

(2010). Forecasting the need for medical specialists in Spain: Application of a system dynamics model. Human Resources for Health, 8(1), 24.

Central Committee of the Communist Party of China. (2016). The 13th five-year plan: For economic and social development of the people’s republic of China (2016–2020). Central Compilation & Translation Press.

China Research Center on Aging. (2015). Development of elderly care institutions in China. Hualing Publishing House.

Colombo

Llena-Nozal

Mercier

Tjadens

(2011). Help wanted? Providing and paying for long-term care. OECD Publishing.

Dang

Wei

Liu

(2018). Survey report on the living conditions of China’s urban and rural older persons (2018). Social Sciences Academic Press.

Frank

(2012). Long-term care financing in the United States: Sources and institutions. Applied Economic Perspectives and Policy, 34(2), 333–345.

10.

Gibson

Gregory

Pandya

(2003). Long-term care in developed nations: A brief overview. AARP Public Policy Institute.

11.

Glass

Gao

Luo

(2013). China: Facing a long-term care challenge on an unprecedented scale. Global Public Health, 8(6), 725–738.

12.

Grimaldo

Orduña

J. M.

Lozano

Ródenas

Garcés

(2014). Towards a simulator of integrated long-term care systems for elderly people. International Journal on Artificial Intelligence Tools, 23(1), 1440005.

13.

Homer

J. B.

Hirsch

G. B.

(2006). System dynamics modeling for public health: Background and opportunities. American Journal of Public Health, 96(3), 452–458.

14.

Jing

(2017). Quantitative forecast analysis of the quantity and structure of disability old in China. Population Journal, 39(6), 81–89.

15.

Kaye

(2014). Toward a model long-term services and supports system: State policy elements. The Gerontologist, 54(5), 754–761.

16.

Lyons

G. J.

Duggan

(2015). System dynamics modelling to support policy analysis for sustainable health care. Journal of Simulation, 9(2), 129–139.

17.

Marshall

D. A.

Burgos-Liz

Ijzerman

M. J.

Osgood

N. D.

Padula

W. V.

Higashi

M. K.

Wong

P. K.

Pasupathy

K. S.

Crown

(2015). Applying dynamic simulation modeling methods in health care delivery research—The SIMULATE checklist: Report of the ISPOR simulation modeling emerging good practices task force. Value in Health, 18(1), 5–16.

18.

Masnick

McDonnell

(2010). A model linking clinical workforce skill mix planning to health and health care dynamics. Human Resources for Health, 8(1), 11.

19.

Ministry of Civil Affairs of the People’s Republic of China. (2010). Statistical report of the People’s Republic of China on civil affairs in 2009. China Statistical Publishing House.

20.

Ministry of Civil Affairs of the People’s Republic of China. (2013). China civil affairs statistical yearbook. China Statistical Publishing House.

21.

Ministry of Civil Affairs of the People’s Republic of China. (2016). Statistical report of the People’s Republic of China on the development of social services in 2015. China Statistical Publishing House.

22.

The Ministry of Human Resources and Social Security of the People’s Republic of China. (2016). Guidance for the pilot implementation of long-term care insurance system. http://www.mohrss.gov.cn/gkml/xxgk/201607/t20160705_242951.html

23.

Qiong

(2015). The path of Chinese long-term care insurance system. Studies in Asian Social Science, 2(2), 23.

24.

Randers

(1980). Elements of the system dynamics method. MIT Press.

25.

Sterman

(2001). System dynamics modeling: Tools for learning in a complex world. California Management Review, 43(4), 8–25.

26.

Peng

Chen

(2015). An analysis on long-term care and influencing factors of the disabled elders: Based on rural-urban difference. Population & Economics, 25(4), 69–76.

27.

Tank-Nielsen

(1980). Sensitivity analysis in system dynamics. In Jørgen

(Ed.), Elements of the system dynamics method (pp. 185–202). MIT Press.

28.

United Nations. (2019). United Nations World Population Prospects: The 2019 revision. https://population.un.org/wpp/Download/Standard/Population/

29.

United Nations Economic and Social Commission for Asia and the Pacific. (2015). Long-term care for older persons in China. http://www.unescap.org/sites/default/files/SDD%20Working%20Paper%20Ageing%20Long%20Term%20Care%20China%20v1-2.pdf

30.

Wang

Tang

(2014). The international comparative study of long-term care insurance system. International Journal of Business and Social Science, 5(2), 239–244.

31.

Wang

Kong

Dong

Yang

Luo

Wei

Chai

Zhai

Liu

(2015). The Chinese pension institution development research. Scientific Research on Aging, 3(8), 13–24.

32.

Yang

A. J.

Fang

Mossialos

(2016). Financing institutional long-term care for the elderly in China: A policy evaluation of new models. Health Policy and Planning, 31(10), 1391–1401.

33.

Zhu

Österle

(2019). China’s policy experimentation on long-term care insurance: Implications for access. The International Journal of Health Planning and Management, 34, 1–14.

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