Ten things to know about elderly care services in China in 2018

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Editor’s Note

This is an abridged and adapted translation of an article published by the China Philanthropy Institute through their WeChat account on the 13 of February 2019. You can see the original here.

1. The national service and quality supervision system for elderly care institutions has taken its preliminary shape

In 2018, new management requirements regarding the security and service quality of elderly care institutions were introduced. The government, especially the civil affairs departments, should establish a long-term mechanism to improve the service quality of the elderly care institutions, strengthen their talent team construction, standardise their services, and enhance the information management of these institutions.

2. The elderly care service market is continuing to open up, and social capital is becoming a significant force

Until 2018, 28 provinces have proclaimed that they introduced social capital into the elderly care service industry and taken measures such as reducing barriers to guarantee their participation. Besides, the licensing policy for running an elderly care institution has been abolished.

At present, social capital is becoming an essential force in the elderly care service industry. For example, from 2015 to 2017 the percentage of registered private elderly care service institutions has increased by 36.36% annually on average.

As for industry development, more than 40 publicly listed real estate enterprises have entered the arena in 2018, and medical enterprises have also started to lay out their ambitions.

3. Three subsidies for the elderly have come to the stage of full implementation

At present all the provinces in China have established an old-age allowance system, 30 provinces have developed a service subsidy system, and 29 provinces have created a nursing subsidy system. Until September 2018, the numbers of ageing people who benefit from the old-age allowance, service subsidy and nursing subsidy have reached 26,800,000, 3,540,000 and 610,000 respectively.

Twenty-one provinces have detailed standards regarding elderly care service and nursing subsidies.

4. A policy combining medical treatments and elderly care has been developed

In 2018 the policy combing medical treatments and elderly care has made progress, which includes encouraging all kinds of collaboration, simplifying or cancelling the administrative procedures, improving the upper-level policy design and so on.

Local governments have also made great efforts. About 30 provinces have come out with suggestions about implementing a regional system combining medical treatments and elderly care. Provinces like Shandong and Anhui have set up demonstration areas, and Henan and Zhejiang have published relevant regulations.

5. Long-term care insurance system experiment is being extended from the national to the provincial level

In 2018, various cities operated an experimental long-term care insurance system in Shandong, Jilin, Jiangsu, Xinjiang, and Anhui.

6. The operational model of community and home care for the elderly is being innovated

By December 2018, there have been 90 cities, three batches in total, conducting experimental reform of community and home care for the elderly supported by central finance. The first two batches including 54 cities that have been assessed, among which 13 cities including Nanjing and Guangzhou and their models have been evaluated highly.

The service list system, as an essential part of the community and home care for the elderly, has been implemented in many places. It not only clarifies the items of the service but also specifies market behaviours by publishing suggested prices and defining the measures. Besides basic services, the list also includes other specialised services such as nutrition consulting and group buying to satisfy the diverse needs of the elderly.

7. The elderly care service system construction is being launched on the national level

In 2018, 16 provinces published particular documents concerning elderly care service. At present, the elderly care service system includes pension security, elderly preferential treatment, elderly rights protection, elderly-friendly environment development, education for the elderly, elderly experts training, elderly care industry development and so on.

8. An experimental tax-deferred commercial pension insurance is being operated in three places

Since May 1st 2018, an experimental tax-deferred commercial pension insurance project has been operated in Shanghai, Fujian and Suzhou Industrial Park, and it is estimated to last for a year. Tax-deferred Pension Policy is an excellent step for the development of the pension system in China, which is expected to provide more security for individuals besides basic pensions.

Tax-deferred pensions allows individuals to defer tax on the part of their income that is used to buy commercial pension insurance until they retire and draw money from the fund. It is more attractive to the middle and high-income groups.

9. The quality of elderly care services has improved in seven fields

The quality of the service has continually been improved in 2018, primarily in benefits, housing, healthcare, transportation, commercial facilities, entertainment, and rights protection.

10. Rural nursing homes are being slowly reformed in terms of their operational model and functional positioning

The severe ageing situation and the emigration of young labour to urban areas highlights the elderly care problem in rural areas. By the end of 2017, there were 15,006 rural elderly care institutions in China with 176,700 beds accommodating 101,300 individuals. As the leading carrier providing elderly care services, the rural nursing home is supposed to be reformed and upgraded. For example, in 2018 Guangdong has tried to combine various operational models; a nursing home in Dazu District in Chongqing not only provided basic daily care services but also offered services such as medical care, rehabilitation, and psychological counselling.