title: Implications of changes in households and living arrangements for future home-based care needs and costs for disabled elders in China.
abstract: OBJECTIVE
  To better understand future home-based care needs and costs for disabled elders in China.
  
  
  METHODS
  To further develop and apply the ProFamy extended cohort-component method and the most recent census and survey data.
  
  
  RESULTS
  (a) Chinese disabled elders and the annual growth rate of the percentage of national gross domestic product (GDP) devoted to home-based care costs for disabled elders will increase much more rapidly than the growth of total elderly population; (b) home-based care needs and costs for disabled oldest-old aged 80+ will increase much faster than that for disabled young-old aged 65-79 after 2030; (c) disabled unmarried elders living alone and their home-based care costs increase substantially faster than those disabled unmarried elders living with children; (d) percent of rural disabled oldest-old will be substantially higher than that of rural population after 2030; (e) sensitivity analyses show that possible changes in mortality and elderly disability status are the major direct factors affecting home-based care needs and costs; (f) caregivers resources under the universal two-child policy will be substantially better than that under the rigorous fertility policy unchanged.
  
  
  CONCLUSIONS
  We discuss policy recommendations concerning pathways to healthy aging with relatively reduced care costs, including reductions of the prevalence of disability, gender equality, the universal two-child policy and resources of caregivers, encouragements of rural-to-urban family migration and elder's residential proximity to their adult children, and remarriages of not-married elders.
authors.affiliation: Duke University, Durham, NC, USA Peking University, Beijing, China zengyi68@gmail.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Duke University, Durham, NC, USA Xiangtan University, Hunan, China.
authors.forename: Huashuai
authors.initials: H
authors.lastname: Chen
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Zhenglian
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Land
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000534:rehabilitation* / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D005544:Forecasting; D017048:Health Care Costs / Q000639:trends*; D006301:Health Services Needs and Demand / Q000639:trends*; D006699:Home Care Services / Q000191:economics / Q000639:trends*; D006801:Humans; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data*
keywords: disability; elderly living arrangements; home-based care costs; household projection; population aging