Chinese long-term care growing, lacking oversight and regulation, similar to U.S. decades ago, researchers say

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The growing demand for nursing homes in China has dramatically outpaced the government's ability to provide oversight, leaving that country's long-term care industry in a state similar to that in the U.S. 40 or 50 years ago, according to a new study.

Researchers at Brown University looked at the shifting demographics in China, and the impact on nursing homes in several cities in that country. By 2040, roughly 22.6% of the Chinese population, or approximately 329 million people, will be over the age of 65, up from just 8.3% today. In several cities around China, the number of nursing homes has grown exponentially over the last few decades, according to the report. In Nanjing, the number of nursing homes has risen from three in 1980 to 140 in 2009; in Tanjin, the number grew from 11 in 1990 to 136 in 2009.

The vast majority of new nursing home construction has been private, and roughly 80% of nursing home revenue in Nanjing comes from private sources, according to the study. Partly because the government has not been involved in the rapid expansion of nursing homes over the last few decades, it also has taken a hands-off approach when it comes to regulation and oversight, according to researchers. In Nanjing in 2009, for example, only 31% of nursing homes employed a doctor, while only 29% employed a nurse. Only 40% of nursing home administrators had achieved a college education, while more than 50% of nursing home staff are untrained rural migrant workers.

“Institution-based long-term care has been very rare in the country in the past,” according to Zhanlian Feng, assistant professor of community health at Brown. “The most urgent thing for China is to plan carefully,” he said. “When I talk to officials, I get the impression that officials know there is a huge challenge and that the aging wave is coming. So they say, ‘Let's build more beds first. Quality? Problems? We'll worry about that later.' That worries me.”

The study appears in today's online edition of the Journal of the American Geriatrics Society.