A Study On Long-term Care Needs And Equalization Of Transfer Payments Forthe Elderly

ObjectiveBased on the analysis of the long-term care needs of disabled elderly in2015 CHARLS data and the calculation of the financial gap of the elderly in different regions,designed the financial transfer payment scheme in different regions.To policy recommendations for the long-term care insurance and insurance financing decisions.MethodsData mining method were used to collect quantitative data.Qualitative data on the long-term care status and needs of disabled elderly in China were collected by using the literature review method.combined with the economic measurement,to estimate of each region of the elderly financial need and calculate the coefficient of transfer payment,to proposed based on the equalization of public service of fiscal transfer payment scheme.Results and Analysis1.Analysis on the basic situation of disabled elderly in ChinaThe elderly with mild disability account for 73.25% of the total number of disabled elderly.The disability rate of urban elderly is lower than that of rural elderly.In the elderly with mild,moderate or severe disability,the proportion of disabled persons decreased with the increase of educational level.In the central region of the China about 58.7% of the elderly with severe disability rated themselves as poor health.The prevalence of chronic diseases in the elderly in different regions was 80.8%(eastern region),83.33%(central region),and 84.54%(western region).From the perspective of mental depression,the depression scores of the elderly with different levels of disability were 23.09(mild disability),24.60(moderate disability),25.93(severe disability),and the mental health status of the disabled elderly can not be ignored.2.Analysis of the needs of long-term care services for disabled elderly in ChinaIn this paper,ADL and IADL scales were used to evaluate the degree of activities of daily living and instrumental activities of daily living of the elderly,so as to obtain the long-term care service needs of the disabled elderly.No matter what degree of the disability or in any regions,toilet use,bathing and dressing ranked in the top three or four places in the needs of ADL.In the IADL individual ability score,climbing several stairs is the most difficulty to complete.In the needs of ADL,mildly disabled elderlywho in the eastern region has difficulty in using the toilet and need help.Elderly with mild disability in central and western regions are at greater risk for increased the degree of disability.The overall scores of the moderately disabled elderly in the eastern,central and western regions showed little difference,and the score of the severely disabled elderly for all the ADL ability needs is above 5 which is in line with the physical characteristics of the severely disabled population.Among the elderly with different degrees of disability the needs of IADL ability were prettysimilar.3.Financial gap and equalization transfer payment scheme for the elderly in different provinceIn order to achieve the equalization of long-term care services,it is necessary to estimate the gap of local financial resources,and then put forward the financial equalization transfer payment scheme.Therefore,this study uses the gap of financial resources to reflect the above contradiction.A total of 9 provinces and cities in Hebei,Jiangsu,Anhui,Henan,Hubei,Hunan,Guangxi,Chongqing,Sichuan have financial gaps for the elderly in2015.Chongqing province has the largest financial gap,and the remaining19 provinces are in surplus.To realize the equalization of public services,the central government shall be by way of transfer payment to compensate for the financial gap of these provinces.Due to the limitation of actual payment capacity,the transfer payment proportionality coefficient needs tobe calculated according to the specific financial gap.The top three provinces according to the coefficient of financial transfer payment for the elderly are: Chongqing(0.257),Sichuan(0.215),Anhui(0.154).SuggestionsFor development of long-term care services for the elderly and establish the long-term care insurance system,puts forward the following suggestion based on perspectives of system establishment,financial responsibility:(1)Accelerate the establishment of social long-term care insurance system;(2)Define the financial responsibility in the financing of social long-term care insurance;(3)To construct a new framework for financing social long-term care insurance;(4)Optimize financial subsidy based on transfer payment coefficient;(5)to standardize the application and management procedures of long-term care insurance fund to ensure the sustainable development of the fund.