Explosive nursing home growth in China
A nursing home industry is booming in China as a rapid increase in the proportion of its elderly population forces a nationwide shift from traditional family care to institutional care, according to new research by Brown University gerontologists, led by Zhanlian Feng, Assistant Professor of community health, and published online in the Journal of the American Geriatrics Society.
The study is the first systematic documentation of the growth and operation of nursing homes in Chinese cities, in a country where the over-65 population will rise from 8.3% of the population today to 22.6% (or 329 million people) in 2040.
The number of nursing homes in Nanjing grew from only three in 1980 to more than 140 in 2009. In Tianjin, where there are 136 nursing homes, only 11 existed before 1990. More than half of the nursing homes in the capital Beijing opened after 2000.
“Institution-based long-term care has been very rare in the country in the past,” said Assistant Professor Feng.
“Even now it is still rare, but we’ve seen explosive growth, which is quite a phenomenon in a country where for thousands of years people have relied almost exclusively on the family for old age support.”
As homes spring up by the score, Assistant Professor Feng said, their operation has been subject to very little of the kind of oversight that Western nations realized decades ago was necessary and at this point the government is largely uninvolved in financing the sector’s growth spurt.
The government encourages development of long-term care facilities in the private sector, Assistant Professor Feng said, but its provision of limited financial subsidies for construction depends on the availability of local resources.
More than three-fifths of 1,208 nursing homes in seven cities around the country are privately owned, and in Nanjing, more than three-quarters of the homes built in the last decade are private. Across the city, 80% of nursing home revenue, on average, comes from private sources. The researchers there also found that patients in privately owned nursing homes tend to be sicker than those in government-owned homes.
In Nanjing in 2009, only 31% of nursing homes employed a doctor and only 29% employed a nurse, and more than half the staff in the city’s homes, on average, are largely untrained rural migrant workers, Assistant Professor Feng said.
“The most urgent thing for China is to plan carefully,” he said.
“When I talk to officials I get the impression that officials know there is a huge challenge and that the ageing wave is coming. So they say, ‘Let’s build more beds first. Quality? Problems? We’ll worry about that later.’ That worries me.”
The National Institutes of Health supported the study through the Fogarty International Center.
