State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, Fujian, 361102, PR China.
School of Economics, Xiamen University, 422 Siming South Road, Xiamen Fujian, 361005, PR China.
Int J Equity Health. 2023 Jul 29;22(1):143. doi: 10.1186/s12939-023-01954-y.
Difficulty in identifying the functional status of older adults creates an imbalance between the supply and demand for community home-based care. Using a multi-level functional classification system to guide care cost measurement may optimize care resources and meet diverse eldercare demands.
The Markov model was used to project the older population size in different functional decline (FD) statuses. The project cost and the man-hour costing method were combined to forecast the cost of community home-based care for older adults with FD.
The projected cost of eldercare increased from 1668.623 billion yuan in 2020 to 2836.754 billion yuan in 2035. By 2035, the total cost for community-based home care for those in pathological development of FD statuses such as "viability disorder," "acute disease," "somatic functional disorder," and "sub-disorder" was projected to be 1094.591 billion, 433.855 billion, 1256.236 billion, and 52.072 billion yuan, respectively, which is 1.24, 1.58, 1.78, and 0.49 times higher than the results by the man-hour costing method. Family caregiving costs are about three times those of professional caregivers.
The escalating cost of providing graded care for older adults, particularly by family caregivers, presenting a significant evidence for the need to optimize resource allocation and develop a robust human resources plan for community home-based care.
由于难以确定老年人的功能状态，导致社区居家养老服务的供需失衡。使用多水平功能分类系统来指导护理成本测量，可能会优化护理资源，满足多样化的养老需求。
采用马尔可夫模型预测不同功能下降（FD）状态下的老年人口规模。结合项目成本和人时成本法预测有 FD 的老年人社区居家养老成本。
预计养老成本将从 2020 年的 16686.23 亿元增加到 2035 年的 28367.54 亿元。到 2035 年，预计“生存障碍”“急性病”“躯体功能障碍”和“亚障碍”等 FD 状态下的社区居家养老的总成本将分别达到 10945.91 亿元、4338.55 亿元、12562.36 亿元和 520.72 亿元，分别是人时成本法预测结果的 1.24 倍、1.58 倍、1.78 倍和 0.49 倍。家庭护理成本约为专业护理人员的三倍。
为老年人提供分级护理的成本不断上升，尤其是家庭护理人员的成本上升，这为优化资源配置和制定社区居家养老的强大人力资源计划提供了重要依据。
