#  Aging Well in Place: International Practices and the Potential Roles of Technology 

 



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**Introduction**

In the 12th Five- Year Plan (2011–15), the Chinese Government outlined a plan for a three-tiered long- term care system which emphasized home-based care as its foundation, supported by community-based services and institutional care. This overarching policy roadmap was reinforced in subsequent high- profile national policy directives. As a general policy guidance, the central government sets targets for a “90-7-3” structure of long-term care services, with 90% of older people receiving care (informal or formal) in their homes, 7% supported by community-based services, and 3% receiving institutional care. This targeted mix of services reflects care preferences of many Chinese elderly; many of whom also prefers to be cared for by family.i,ii However, the development of home/community-based care has been slow, due in part to limited organized financing for these services and underdeveloped service provision, including a major shortage of qualified manpower and the delayed adoption of technological tools.iii Unfortunately, there are limited systemic analyses of the financing and delivery of home-based care to help China develop affordable, equitable and effective home care that serves the needs of the elderly population.

This study proposes several analyses to inform the design of an effective home-based, long-term care system in China that ensures that older adults receive the necessary support and assistance to lead dignified lives. Specifically, the proposed project aims to answer the following questions:

(i) What are the different options for financing home-based care and what are their pros and cons? (ii) What should be included in the benefit package for home care? Should cash benefits be included to support care provided by families? (iii) How should China best organize formal and informal caregiving of home-based care and how to assure quality? (iv) What role can technology play in enhancing/facilitating home care? Are technology substitutes or complements to human care? How should technology be financed? How should their use be regulated (if at all) to ensure safety and quality?

The proposed project involves International review and comparative analyses which aims to identify best practices in organizing, financing, and delivering home-based long-term care for older adults, including the use of technology for home-based care. We will review and compare several Asian countries/territories with similar social values and perspectives of familial and community relationships, e.g., Hong Kong, Taiwan, Singapore and Japan. We also plan to include a few high-income countries with established long term care systems that have been reasonably successful in promoting home based care, e.g., Germany. The scope of the review will cover financing models (tax revenue vs social insurance vs charitable contributions vs self-pay), services and benefits (in kind vs cash), eligibility and assessment, service provision (formal vs informal; government vs private for profit vs community vs family), training of workforce and carers, coverage of technology, quality assurance and accreditation, and policy and regulatory frameworks—all with consideration to disability level.