Long-term Care System For Older People In Changning District In Shanghai

Objective: To put forward policy suggestion for building a long-term caresystem and its financing strategy, we did a survey and analyzed thedemand and expenditure for long-term care among older people inChangning district in Shanghai. Methods: Based on a survey in theactivities of daily living and the demand for long-term care on1576peopleover60years old, we weighted and estimated the expenditure forlong-term care for older people in the district. Results: According to theactivities of daily living scale,31.34%of all objects had decline in theability of living to different extent. Age, the number of chronic diseasesaffected and the coverage by medical insurance are three majorindependent factors influencing the activities of daily living of the objects.It was found that27.67%people needed care for daily living,25.72%people needed care for chronic diseases,23.29%people neededrehabilitative care,19.29%people needed professional nursing care and18.53%people needed sickbed care. It was estimated that152.74millionUS dollars (0.947billion yuan) would be needed for long-term care inChangning district in Shanghai for year2012. This was1.26%of localGross Domestic Product and was8.33%of local fiscal expenditure. Conclusions: Our study provided a method that can help estimate theexpenditure for long-term care for older people in a region so as to assistthe policy-makers in building a public long-term care program for olderpeople. A socialized long-term care service system should be establishedin the support of appropriate law enforcement on financing, a good fiscalpolicy for service providers and an effective human resource reservoir.