Department of Geriatrics, Second Hospital of Tianjin Medical University, Tianjin, China.
Department of Geriatrics, Chinese People's Liberation Army General Hospital, Beijing, China.
J Am Geriatr Soc. 2018 Aug;66(8):1462-1468. doi: 10.1111/jgs.15424. Epub 2018 Jul 5.
China faces an aging tsunami. By the end of 2016, the number of older adults aged 60 and older reached 230 million. This number is projected to reach 418 million by 2035 and peak at 487 million by 2053. The number of individuals aged 80 and older, the oldest adults, reached 26 million and continues to grow by 1 million a year. The socioeconomic context, characterized by an inverted pyramid family structure and the number of "empty nesters," has greatly compromised traditional Chinese family support for older adults. This article aims to provide an overview of geriatrics development in China. It begins with a brief account of the dramatic demographic shift, major socioeconomic factors, China's healthcare system, and reform related to senior health with a historical perspective. It then describes recent advances in government policy and support and development of a geriatrics physician workforce, care models, primary care networks, and privately owned senior care facilities and support services. Although it is impossible to cover all aspects of the topic, it is hoped that this article provides readers an overall picture of Chinese geriatrics and senior healthcare development in a complex and evolving healthcare system. Geriatrics communities in the United States and around the world will undoubtedly learn and benefit from the unparalleled and continued efforts to address this unprecedented opportunity and challenge in China.
中国面临老龄化海啸。截至 2016 年底,60 岁及以上老年人口达到 2.3 亿。预计到 2035 年将达到 4.18 亿,到 2053 年达到峰值 4.87 亿。80 岁及以上的老年人数量,即最年长的老年人,达到 2600 万,并以每年 100 万的速度增长。社会经济背景的特点是倒金字塔形的家庭结构和“空巢家庭”的数量,这极大地削弱了中国传统家庭对老年人的支持。本文旨在概述中国老年医学的发展。它首先简要介绍了人口结构的巨大变化、主要的社会经济因素、中国的医疗保健系统以及与老年人健康相关的历史改革。然后描述了政府政策和支持的最新进展,以及老年医学医师队伍、护理模式、初级保健网络、私营老年护理设施和支持服务的发展。尽管不可能涵盖该主题的所有方面,但希望本文能为读者提供中国老年医学和老年人医疗保健发展的全貌,在中国这个复杂且不断发展的医疗保健系统中。美国和世界各地的老年医学社区无疑将从中国应对这一前所未有的机遇和挑战的无与伦比和持续努力中学习并受益。