Interpretation of the 2023 National Report on the Development of Elderly Care in China

The 2023 National Report on the Development of Elderly Care in China provides a comprehensive overview of the country’s population aging status and the measures taken to support the aging population. The report reflects China’s commitment to strengthening elderly care services, social security, healthcare, and ensuring the welfare of its elderly citizens. Here is an interpretation of the key highlights from the report. Overview of population aging As of the end of 2023, China’s population aged 60 and above reached 296.97 million, representing 21.1% of the total population. Compared with 2013, when the proportion was 14.9%, this demonstrates a substantial increase in the elderly population. The number of individuals aged 65 and above was 216.76 million, accounting for 15.4% of the total population. This growing proportion of elderly citizens reflects the significant challenge posed by an aging population in China. The dependency ratio of the elderly (ie, the number of elderly people supported by the working-age population) increased to 22.5%, indicating a rising burden on the younger generation to support the elderly. Development of social security for the elderly Pension insurance The pension insurance system continued to expand in 2023, with the number of people covered reaching over 1.066 billion, an increase of >13 million compared with the previous year. This includes both urban employees and rural residents. The enterprise annuity system also saw stable growth, with 141,700 enterprises providing annuity plans to 31.44 million employees. In addition, the third pillar of pension insurance, involving personal pension schemes, has been actively developed and piloted in 36 cities. By the end of 2023, the number of participants had exceeded 50 million. These efforts highlight the growing emphasis on building a multilayered pension system in China. Health care services for the elderly The health care insurance system for the elderly has maintained stable coverage, with over 1.333 billion people covered by basic medical insurance, ensuring a coverage rate above 95%. Participation in employee medical insurance grew by 8.52 million people compared with the previous year, and retirees covered by medical insurance also increased by 3.7%. Cross-region medical settlements have shown substantial progress, providing greater convenience for the elderly who require medical services away from their registered hometowns. In 2023, 243 million cross-region medical treatments were settled, with a total cost of 711.1 billion yuan, demonstrating efforts to ease medical access for seniors across different regions. Long-term care insurance The long-term care insurance pilot program continued to progress steadily in 2023, with nearly 18.33 million participants in 49 pilot cities. Around 1.34 million elderly people received long-term care benefits, with 8080 designated care facilities providing services and more than 300,000 care workers employed. This reflects the government’s commitment to addressing the care needs of its aging population. Social assistance and basic livelihood support The report highlights significant progress in providing social assistance to elderly citizens. By the end of 2023, nearly 6.64 million urban residents were receiving minimum living allowances, of which over 1.42 million were elderly. In rural areas, 33.99 million people received minimum living allowances, including around 12.94 million elderly individuals. In addition to minimum living allowances, various subsidies were provided to the elderly to support their basic living needs. The government has made efforts to provide targeted financial aid and support to elderly citizens, especially those in extreme poverty. Elderly care services system China has made strides in developing its elderly care services system. By the end of 2023, the country had constructed 3476 convenience service circles in 150 pilot areas, involving various elderly care and community dining facilities, benefiting ~64.55 million residents. There were 404,000 elderly care institutions and facilities, with over 8.23 million beds available. Registered nursing beds accounted for nearly 59% of all beds, which shows a focus on meeting the health care needs of elderly citizens with higher care demands. Moreover, a range of subsidies was provided to support the elderly in accessing care services. By the end of 2023, 35.48 million elderly people were receiving high-age subsidies, 6.21 million were receiving elderly care service subsidies, and nearly 1 million were receiving nursing subsidies. The government spent 42.17 billion yuan on elderly welfare and 22.32 billion yuan on elderly care services. Conclusions The 2023 report highlights China’s ongoing efforts to support its aging population through expanded social security, enhanced health care services, improved long-term care, and increased social assistance. With a rapidly growing elderly population, the country faces significant challenges, but the comprehensive measures outlined in the report suggest that China is committed to ensuring the well-being and dignity of its senior citizens. Moving forward, continuing to develop the elderly care system, improving financial sustainability, and enhancing health care services will be crucial in meeting the needs of an aging society. Conflict of interest The authors have no conflicts of interest to declare.