中国老年人口健康状况及其家庭照料需求预测

The Prediction of Health Status and Family Care Needs of the Elderly People in China

中国人口老龄化快速发展,失能、半失能老年人口规模迅速扩大,老年照料需求快速增加。科学预测不同失能状况老年人口规模及其照料服务需求是推动老年照护服务体系建设的重要基础。文章基于中国老年健康影响因素跟踪调查(CLHLS)数据,使用Markov模型测算中国分性别、分年龄段老年人口健康状况转移矩阵,运用队列要素预测法、多元回归法等预测得到2020—2035年中国不同失能状况老年人口规模及其照料服务人员需求规模、家庭照料经济成本。预测结果显示:中国失能老年人口规模呈现增长态势,从2020年的1946万人增至2035年的3424万人,失能老年人口的比例从2020年的7.4%小幅增至2035年的7.9%,且中重度失能老年人口增幅更快,2035年时轻度失能老年人口规模相比2020年增加66%,中重度失能老年人口规模相比2020年增加92%。女性失能老年人口规模增速快于男性,80岁及以上老年人口失能比例增长更快,2035年男性70~79岁、80~89岁、90+岁三个年龄组失能老年人口规模分别为2020年的1.53倍、1.92倍、1.94倍;2035年女性三个年龄组失能老年人口规模分别为2020年的1.72倍、2.29倍、2.52倍。老年家庭照料需求将呈现快速增长态势,家庭照料服务人员需求量从2020年的2795万人增至2035年的4863万人,增长74%。2020—2035年健康老年人口的照料服务人员需求量占总需求量的比例在57%左右,中重度失能老年人口需求量占比在24%左右,轻度失能老年人口需求量占比在19%左右。60~69岁老年人口所需的照料服务人员占比最高,90岁及以上年龄组对照料服务人员的需求量增长更快。老年人口家庭照料经济成本从2020年的3027亿元增至2035年的11676亿元,将增长近3倍。中重度失能老年人口所需的家庭照料现金成本相比2020年增长3.1倍,轻度失能老年人口所需的家庭照料现金成本相比2020年增长2.6倍。男性老年人口所需家庭照料现金成本低于女性老年人口,且增速也低于女性老年人口。本研究基于定量预测结果提出积极推进健康老龄化,加大促进生育的政策支持力度,尽快推广长期照护保险制度,以赋能家庭为着力点加强失能老年人口的支持体系建设,大力发展老年护理服务业,大力发展养老护理职业教育等政策建议。

The rapid development of population aging in China has brought about a rapid expansion in the size of the population of disabled and semi-disabled elderly people and a rapid increase in the demand for elderly care,so scientific prediction of the size of the elderly people with different levels of disability and their demand for care services is an important basis for promoting the construction of a sound elderly care service system.Based on the Chinese Longitudinal Healthy Longevity Survey(CLHLS)data,this study utilized the Markov model to calculate the health status transition matrix of the elderly people in China by gender and age.Using the cohort factor prediction model and multivariate regression analysis,the scale of elderly individuals with various disability statuses and their family care needs in China from 2020 to 2035 was predicted and analyzed.The analysis reveals the following trends:The number of disabled elders in China is on the rise,and it will increase from 19.46 million in 2020 to 34.24 million in 2035.The proportion of disabled elders within the elderly population will experience a slight increase,from 7.4%in 2020 to 7.9%in 2035,with a faster increase observed among those with moderate and severe disabilities.By 2035,the number of elderly individuals with mild disabilities is expected to rise by 66%compared to 2020,while those with moderate and severe disabilities will see a 92%increase.Disability rates are increasing faster among women than men,particularly among those aged 80 and over.In 2035,the disabled elderly people in the three age groups of men aged 70~79,80~89,and 90+years old will be 1.53 times,1.92 times,and 1.94 times that of 2020,respectively.Similarly,in 2035,the number of disabled elderly women in the same age groups will be 1.72 times,2.29 times,and 2.52 times that of 2020,respectively.The demand for elderly care services is expected to undergo rapid growth.The need for family care providers is projected to increase by 74%,from 27.95 million in 2020 to 48.63 million in 2035.Over the period from 2020 to 2035,the demand for family care providers for healthy elderly individuals is estimated to comprise about 57%of the total demand,while those for elderly individuals with moderate and severe disabilities and mild disabilities will account for about 24%and 19%respectively.The age group of 60~69 exhibits the highest demand for family care,with the age group of 90 and above experiencing faster growth in demand.The economic cost of family care for the elderly is projected to nearly triple,rising from 302.7 billion yuan in 2020 to 1167.6 billion yuan in 2035.Specifically,the economic cost of home care for elderly individuals with moderate and severe disabilities is expected to increase by 3.1 times compared to 2020,while for those with mild disabilities,it will increase by 2.6 times.Based on these prediction results,this paper proposes several policy recommendations.