A Study on the Scale and Affordability of Public Finances of Basic Care Services for the Elderly with Dementiaunder the COVID-19 Pandemic in China

Abstract

The 2019 novel coronavirus disease (COVID-19) pandemic has presented an unprecedented threat to global public health, posed unique risks to the elderly with dementia (EWD). The aim of this study is to explore the funding model of basic care services for EWD and calculate the scale and affordability of public finances under the COVID-19 pandemic in China. A linear regression model on the prevalence of dementia by age group was used to predict the number of EWD in China in 2018-2050, and a macro-simulation model was used to predict the cost of basic care services for EWD and the financing burden of public finances in China in 2018-2050.The number of EWD in China is projected to rise from 13.23 million in 2018 to 25.78 million in 2030 and 63.71 million in 2050, and the cost of basic care services for EWD paid by the government's public finance is projected to increase from $52.27 billion in 2018 to $197.27 billion in 2030 and $1047.78 billion in 2050. Public financial payments for basic care services for EWD as a percentage of GDP are projected to increase from 0.38% in 2018 to 0.75% in 2030 and 1.85% in 2050, while the percentage of the government's general public budget expenditure is projected to increase from 1.57% in 2018 to 3.05% in 2030 and 7.54% in 2050. The proportional increase in public expenditure after the implementation of basic care services for EWD by the Chinese government is limited, and the pressure on public finances is not expected to be high but within the affordable range. The Chinese government has the financial capacity to guarantee the sustainable running of the long-term care insurance (LTCI) system for EWD during and after the COVID-19 pandemic.