Chu Leung-Wing, Chi Iris
Sau Po Centre on Aging, The University of Hong Kong, Hong Kong.
J Am Med Dir Assoc. 2008 May;9(4):237-43. doi: 10.1016/j.jamda.2008.01.008. Epub 2008 Apr 8.
China will face a dramatic transition from a young to an aged society in the coming 30 to 40 years. In 2000, there were 88,110,000 persons aged 65 years and older, which represented 7% of the population. This percentage is projected to increase to 23% in 2050. Regarding health and long-term care for older adults, the current challenge is to build a comprehensive system of care for older adults. Nursing home care is an inevitable care model for frail older adults in China, which is largely sponsored by the government of China with contributions from some nongovernment organizations and private investors. China is a large country. Within the country, long-term care varies greatly between rural and urban areas, and among the different economic developing areas. In urban and better-developed areas, the range of services exists; however, in rural and less-developed areas, the range of services is limited. The "Star Light Program" and "Beloved Care Engineering" were recent government initiatives to improve aged care. They were launched in 2001 and have dramatically increased the number of both senior centers and nursing homes for older adults. While the quantity of nursing homes is still inadequate with an additional mismatch problem between the supply and demand, the quality of care in most nursing homes is suboptimal. At present, most administrative and frontline workers in nursing homes have received little training in elder care. There is a need for good-quality structured training in long-term care for all types of staff. Moreover, quality standard for care, including standard setting, assessment, and monitoring, is an important issue and needs substantial improvement for nursing homes in China. Currently, 1.5% of older people live in nursing homes and apartments for older people. Because of the peculiar 4-2-1 family structure in China, we expect the prevalence of nursing home placement of older adults will increase in the coming years. The government of China has realized that it is financially not sustainable to expand in this area using only the government's resources. The current policy is to encourage private and foreign investors to participate in the nursing home business in China.
在未来30到40年里，中国将面临从年轻社会向老年社会的巨大转变。2000年，65岁及以上老年人口有8811万，占总人口的7%。预计到2050年，这一比例将升至23%。关于老年人的健康和长期护理，当前的挑战是建立一个全面的老年人护理体系。养老院护理是中国体弱老年人不可避免的护理模式，主要由中国政府资助，一些非政府组织和私人投资者也有参与。中国是一个大国。国内长期护理在城乡之间以及不同经济发展地区差异很大。在城市和较发达地区，服务种类较多；然而，在农村和欠发达地区，服务种类有限。“星光计划”和“爱心护理工程”是政府近期改善老年护理的举措。它们于2001年启动，大幅增加了老年活动中心和养老院的数量。虽然养老院数量仍然不足，且存在供需不匹配问题，但大多数养老院的护理质量欠佳。目前，大多数养老院的行政和一线工作人员几乎没有接受过老年护理培训。各类工作人员都需要接受高质量的长期护理结构化培训。此外，护理质量标准，包括标准制定、评估和监测，是一个重要问题，中国的养老院需要大幅改进。目前，1.5%的老年人居住在养老院和老年公寓。由于中国特殊的4-2-1家庭结构，我们预计未来几年老年人入住养老院的比例将会增加。中国政府已经意识到仅靠政府资源在这一领域扩张在财政上是不可持续的。当前政策是鼓励私人和外国投资者参与中国的养老院业务。
