Study On The Long-term Care And Labor Demand Of The Elderly

Since 2010,our country is faced with the increasingly serious problem of aging population and fewer children,due to baby boom during 1950-1960s and one-child policy began in the late 1970s.At the same time,the rapid development of market economy and urbanization makes the labor flow frequently,female labor participation rate increased,family size gradually reduced,the elderly living alone increased,all of these are telling us that the traditional family pension mode is disappearing.Therefore,the main service principal of the elderly long-term care needs to transfer to the society and develop into a social,professional and industrialized way to solve the insufficient care ability of family.However,on the other hand,the long-term care market for the elderly in our country is still in the primary stage,construction and service facilities is not mature,the optimizing and improving the market development prospect is strictly dependent on accurate industry forecasts,but the current domestic related research is rare.Therefore,the purpose of this study is to measure the dynamic changes of the elderly long-term care needs,and combine the supply situation to analyze the opportunities and challenges facing the industry,which can provide mathematical support for the optimization of the long-term care industry for the elderly and emancipates the family labor force and promotes the sustainable development of the whole society and economy.This research adopts the method of combining theoretical analysis with empirical research,which mainly involves the following four aspects:First,literature review.Through literature review and combing make definition of "aging population" and"long-term care".And by consulting and summarizing the related literature about "the determination of the self-care ability" and "long-term care needs of the elderly" to find the breakthrough point of this research;Second,theoretical analysis.Based on related theories of Malthus's theory,neoclassical economics and population transformation theory,this paper expounds the theoretical mechanism of the aging of population in China from the aspects of technological progress,economic growth,childbearing and education policy,so as to provide theoretical basis for this research;Third,mathematical statistics and econometric analysis.Use dual sex Leslie expansion model to predict the dynamic evolution of China's population aging(the size and proportion)after the implementation of the "two-child" policy.Apply mlogit model to analyze the influencing factors of the elderly care needs and ordered logit model to analyze the influence of nursing level and living mode on the quality of life of the disabled elderly.Fourth,descriptive statistical analysis and proportion step method.Based on CLHLS data,use descriptive statistics method to analyze the distribution of elderly self-care ability in all age groups,and combined with the prediction results of the elderly population scale to calculate the total amount and structural change of disabled elderly population.The purpose of this study is to analyze the long-term care need for the elderly in China.The research content is divided into three parts:First,predict the process of aging population.Based on Malthusian-ism,the new classical economic theory and modern theory of population transformation to expound the formation mechanism of China's aging population at the theoretical level.On reviewing the evolution of China's population policy,use Leslie model is to analyze and predict the trend of the population aging in the future;Second,estimate the long-term care needs of the elderly.Combined with the prediction,use the CLHLS data to calculate the scale changes and the structure distribution of the disabled elderly,then estimate the care needs of the disabled elderly accordingly;Finally,put forward the further optimization and improvement of the long-term care market.Through analyzing the supply status of the long-term care market for the elderly and combined with the demand forecast results,to figure out the opportunities and challenges faced in the long-term care market,and then present the main conclusions and policy recommendations of this study.Four main conclusions are obtained in this research:First,the trend of aging population in China can not be reversed.Since the reform and opening up of China in 1978,our country fully accepted the theory of Malthusian-ism and had carried out the family planning policy for more than 30 years,which contributes to a dilemma of aging and fewer children.The experience of developed countries shows that it is difficult to change the age structure of the population even if the population policy is fully liberalized in the future.And this research bases on the "two-child" policy and uses the double sex Leslie expansion model to predict the aging population process,the results show that China will enter a super aging society during the 2028-2030 years,and the aging population is accelerating in the next 30-40 years.The number of people older than 65 will increase from 170 million to 349 million during 2015-2052,and the number of people older than 80 will increase from 32 million to more than 100 million;In 2015-2050s,the proportion of people older than 65 in the total population will increase from 12.36%to about 30%and for people older than 80 it will increase from 2.36%to about 9%,the elderly dependency ratio of people older than 65 will increase from 17.23%to more than 50%,and for people older than 80 it increase from 3.28%to about 16%,the child aged ratio will increase from 77%to 200-300%.Second,the number of disabled elderly people is increasing,and the long-term care needs of the elderly are strong.In order to analyze the demand and its trend of social service for the elderly,this research sets up a criterion of elderly self-care ability and build the care service system.The results showed that community care was highly favored,the proportion is 86.86%,84.81%and 84.36%in mild,moderate and severe disabled elderly,separately,and for institutional care,the proportion is only 2.43%,2.74%and 1.23%.The demand for social services of elderly will increase rapidly and reach its peak in the middle of this century.In the 2015-2055 years,the number of disabled elderly with community care needs will increase from 48.54 million to 131.86 million,and the demand for caregivers will increase from 10.57-13.26 million to 29.07-36.45million;the number of disabled elderly with institutional care needs will increase from 1.35 million to 3.67 million,and the demand for caregivers will increase from 0.31-0.39 million to0.85-1.07million.Third,institutional facilities supply is sufficient and the gap in the community facilities is huge.The facilities supply of community care can not meet the needs,by the end of 2016,the community pension bed supply number is 3.16 million,while the demand is more than 3.95 million,and the bed gap is at least 1.16 million,and by 2053,the demand for community pension beds was further increased to more than 11.59 million,and the burden of building facilities for community care is severe.The facilities supply of institutional care is adequate,by the end of 2016,the institutional pension bed supply number is 3.79 million,and it is more than the peak demand of 3.67 million in 2055.Therefore,there is little pressure on the construction of institutional care facilities in the future,but there is still a problem of structural adjustment,during 2011-2016,the utilization rate of bed reduced from 75.7%to 58.0%,and for urban pension institutions the utilization rate reduced from 73.3%to 50.1%.The continuous decline of the utilization rate of the bed indicates that there exist blind expansion and lack of reasonable planning for the institution construction in China.Fourth,the labor supply is severely short and the quality of service is very low.At the end of 2016,the number of labor supply in institutional care was 339 thousand,which was basically equal to the demand.While to the year of 2034 the demand for nursing home workers will be increased by 300-400 thousand,at the peak of demand in the year of 2055,it will further increased by 500-700 thousand.The demand for community care workers is huge and grows rapidly.The demand for workers is 10.58-13.26 million in 2015,and it will further increase to 29.07-36.45 million by 2055.While the supply number of nursing staff in the community is only 304 thousand by the end of 2016.At the meanwhile,the utilization rate of institutional bed is less than 60%,and the utilization rate of community beds is less than 35%.The coexistence of huge supply-demand gap and higher bed vacancy rate reflects the fact that the quality of social care in our country is not high enough to meet the needs of care.By the end of 2016,the number of professional skills,announced by the Ministry of civil affairs,was only 9160,accounting for 1.42%of the total labor force.The shortage of labor supply and the low quality of care service are mainly due to the lack of industry operation norms.The main contribution of the research is the following three points:First,define the evaluation criteria for the self-care ability of the old people.Up to now,the criteria for assessing the self-care ability of the elderly are not yet unified.The basis of its evaluation could mainly divided into 3 aspects:? Based solely on the completion of ADLs for the elderly to judge the life self-care ability of the elderly,such as Zeng Yi,et al.(2012),and the research group of China Aging Science Research Center(2011);?Use the combination of ADLs and IADLs to determine whether the elderly are disabled or disabled,such as the national long term care survey(NLTCS),Hu Hongwei et al.(2015);?Considering the cognitive function,along with ADLs and IADLs,to judge the self-care ability of elderly,such as Huang kuangshi(2014),Huang sa(2012)etc.Based on the existing literature,the research puts forward a evaluation method of of the self-care ability as the criterion to determine whether the elderly need to be cared and their intensity.Second,build a long-term care service system for the elderly.The related research is less involved in the construction of the service system,only Yuwei et al.(2012)and Fengting at al.(2016)had taken it into consideration,but the exposition of the construction principles and contents in the two literature are not clear.In this research,the long-term care service system is built on the basis of the subjective desire of the disabled elderly,which is consistent with the hypothesis that "the actor seeks to maximize the utility" in microeconomics,and it identifies the types of care and the number of caregivers for the elderly with different degrees of disability.Third,study the dynamic evolution of population aging and care service demand.The current domestic literature has rarely studied the dynamic evolution of aging population or quantified the demand for social services of the elderly.The existing literature,like Huangsa et al.(2012)and Huhongwei(2015)and Wufan(2016),only predicted short intervals of long-term care demand,which can not reflect the change trend of aging population.This study adopts double sex Leslie model to predict the dynamic expansion evolution of aging population,and calculate the quantity of the elderly who needs long-term care and the needs of the industry's caregivers and the demand of industry caregivers,so as to provide data support for developing the long-term care industry in China.