Review Article
Long-Term Care Arrangements in Rural China: Review of Recent Developments

https://doi.org/10.1016/j.jamda.2009.07.008Get rights and content

Developing long-term care systems for the elderly has become an increasingly urgent policy issue in China, especially in rural areas. This article provides an overview of the current status of long-term care development in rural China and discussion on the future development of institutional care and its policy implications. Formal long-term care systems are emerging but remain in the preliminary stages of development. Several policy considerations and practical implications deserve further attention: increases in regional and national government funding, integration of long-term care with the acute health care system, and creating more multilevel and multifunctional LTC facilities with a well-trained and skilled workforce.

Section snippets

Methods

We used an iterative approach to identify eligible publications for this review. We searched articles and research and policy reports published in English or Chinese between 1979 and May 2009. Two strategies were used to identify potentially relevant literature. First, we conducted a database search using 3 English literature databases: PubMed (which includes MEDLINE and other life science journals for biomedical articles), PsycInfo, and Google Scholar. For Chinese literature, we also searched

Results

Limited studies have been conducted in the areas of LTC in China. Among the limited research, most studies have been concentrated on changing family structures and relationships,12, 13 attitudes toward institutional care,4, 14 community-based LTC,15, 16 and institutional care in urban China.17, 18 Most of the Chinese studies have focused on the need for LTC19, 20 and the public challenges and policy recommendations for developing LTC.21, 22 Few studies have examined the status and current

Discussion

Long-term care systems are emerging in rural China, particularly in wealthy areas near the eastern coast, but many of these systems are still in the preliminary stages of development. Additionally, the unequal development of China's economy continues to have a profound impact on the growth and development of various LTC systems across regions, in terms of facilities and infrastructure, residents' characteristics such as level of care needed, sufficient and appropriate staffing, uniform

Conclusions

With a growing population of elders, declining family sizes combined with a greater migration of young adults to cities and an increase of individuals' living standards, there is a pressing need for LTC in China. In the meantime, rural elders and their families are more accepting of institutional care for elders than in the past, especially in more economically developed areas. In response to these needs, formal LTC systems are emerging but remain in the preliminary stages of development.

Acknowledgments

We thank Corely Remle, PhD, for his editorial assistance and Mrs. Zhang Xuan for her assistance in literature search.

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