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Long-term care service needs and planning for the future: a study of middle-aged and older adults in Hong Kong

Published online by Cambridge University Press:  22 August 2017

ALEX JINGWEI HE*
Affiliation:
Department of Asian and Policy Studies, The Education University of Hong Kong, Tai Po, Hong Kong.
KEE-LEE CHOU
Affiliation:
Department of Asian and Policy Studies, The Education University of Hong Kong, Tai Po, Hong Kong.
*
Address for correspondence: Alex Jingwei He, Department of Asian and Policy Studies, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong E-mail: jwhe@eduhk.hk

Abstract

Long-term care (LTC) planning is important in helping the older people tackle their future needs better. The needs for LTC services represent generational characteristics as they may be different between the current and upcoming cohorts of older adults. However, very few studies have examined the cohort differences in terms of their expected utilisation of LTC services, while understanding the patterns is crucial in helping policy makers prepare for the development of LTC services. This study fills the research gap by examining the plans and expectations for LTC services of 1,613 middle-aged and older persons in Hong Kong with data collected from a telephone survey. By applying the Andersen Model to examine LTC expectations, this study analyses the LTC needs and plans of the middle-aged and older cohorts of Hong Kong adults, as well as their associated factors, with a multiple logistic regression method. Both gender and birth cohort were examined individually and in combination. Birth cohort and gender have been found to exert an impact on all aspects of LTC needs and planning to varying degrees. The findings are interpreted and contrasted with those of a key study based in the West, with reference to the contextual characteristics of Hong Kong. This study furthers the scholarly understanding on LTC needs and planning and their cohort effect, and draws evidence-based recommendations for LTC development in Hong Kong, a rapidly ageing East Asian society.

Type
Article
Copyright
Copyright © Cambridge University Press 2017 

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References

Andersen, R. M. 1995. Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior, 36, 1, 110.Google Scholar
Black, K., Reynolds, S. L. and Osman, H. 2008. Factors associated with advance care planning among older adults in southwest Florida. Journal of Applied Gerontology, 27, 1, 93109.Google Scholar
Bradley, E. H., McGraw, S. A., Curry, L., Buckser, A., King, K. L., Kasl, S. V. and Anderson, R. 2002. Expanding the Andersen Model: the role of psychosocial factors in long-term care use. Health Services Research, 37, 5, 1221–42.Google Scholar
Brown, J. R. and Finkelstein, A. 2008. The interaction of public and private insurance: Medicaid and the long-term care insurance market. American Economic Review, 98, 3, 1083–102.Google Scholar
Bucher-Koenen, T. and Lusardi, A. 2011. Financial literacy and retirement planning in Germany. Journal of Pension Economics and Finance, 10, 4, 565–84.Google Scholar
Burholt, V. and Windle, G. 2001. Literature Review for the Strategy of Older People in Wales: Social Inclusion for Older People. Available online at http://www.wales.gov.uk/subisocialpolicy/content/ssg/LR3.pdf [Accessed 17 March 2016].Google Scholar
Campbell, J. C., Ikegami, N. and Kwon, S. 2009. Policy learning and cross-national diffusion in social long-term care insurance: Germany, Japan and the Republic of Korea. International Social Security Review, 62, 4, 6380.Google Scholar
Caro, F. G., Yee, C., Levien, S., Gottlieb, A. S., Winter, J., McFadden, D. L. and Ho, T. H. 2012. Choosing among residential options: results of a vignette experiment. Research on Aging, 34, 1, 333.Google Scholar
Census and Statistics Department 2009. Socio-demographic profile, health status and self-care capability of older persons. Thematic Household Survey Report 40, Census and Statistics Department, Hong Kong SAR Government, Hong Kong.Google Scholar
Census and Statistics Department. 2012. 2011 Hong Kong Population Census. Available online at http://www.census2011.gov.hk/en/main-table.html [Accessed 19 August 2015].Google Scholar
Chan, L. S. and Chou, K. L. 2016. Poverty in old age: evidence from Hong Kong. Ageing & Society. Published online August 30, 2016, doi:10.1017/S0144686X16000817.Google Scholar
Chau, P. H. and Woo, J. 2008. How Well Are Seniors in Hong Kong Doing? An International Comparison. The Hong Kong Jockey Club Charities Trust, Hong Kong.Google Scholar
Chi, I. 2001. Long-term care policy for elders in Hong Kong. Journal of Ageing and Social Policy, 13, 2/3, 137–53.Google Scholar
Chong, A. M. L., Kwan, C. W., Chi, I., Lou, V. W. and Leung, A. Y. 2014. Domestic helpers as moderators of spousal caregiver distress. Journals of Gerontology: Psychological Sciences and Social Sciences, 69B, 6, 966–72.Google Scholar
Chong, A. M. L., Ng, S. H., Woo, J. and Kwan, A. Y. H. 2006. Positive ageing: the views of middle-aged and older adults in Hong Kong. Ageing & Society, 26, 2, 243–65.Google Scholar
Chou, K. L., Chi, I. and Chong, A. M. L. 2006. The utilization of aged care services by the frail elderly and their family cargivers. Hong Kong Medical Journal, 12, 1, 79.Google Scholar
Chou, K. L., Chow, N. W. S. and Chi, I. 2004. Preventing economic hardship among Chinese elderly in Hong Kong. Journal of Ageing and Social Policy, 16, 4, 7997.Google Scholar
Chou, K. L., Chow, N. W. and Chi, I. 2005. Voucher system for long term care in Hong Kong. Journal of Ageing and Social Policy, 17, 2, 85106.Google Scholar
Chou, K. L. and Leung, J. C. B. 2008. Disability trends in Hong Kong community-dwelling Chinese older adults, 1996, 2000, and 2004. Journal of Aging and Health, 20, 4, 385404.Google Scholar
Chou, K. L., Yu, K. M., Chan, W. S., Wu, A. M., Zhu, A. Y. and Lou, V. W. 2015. Perceived retirement savings adequacy in Hong Kong: an interdisciplinary financial planning model. Ageing & Society, 35, 8, 1565–86.Google Scholar
Chow, N. W. 1999. Diminishing filial piety and the changing role and status of the elders in Hong Kong. Hallym International Journal of Aging, 1, 1, 6777.Google Scholar
Chui, E. 2008. Ageing in place in Hong Kong: challenges and opportunities in a capitalist Chinese city. Ageing International, 32, 3, 167–82.Google Scholar
Chui, W. T. E. 2011. Long-term care policy in Hong Kong: challenges and future directions. Home Health Care Services Quarterly, 30, 3, 119–32.Google Scholar
Chung, R. Y., Tin, K. Y. K., Cowling, R. J., Chan, K. P., Chan, W. M., Lo, S. V. and Leung, G. M. 2009. Long-term care cost drivers and expenditure projection to 2036 in Hong Kong. BMC Health Services Research, 9, 172.Google Scholar
Costa-Font, J. and Courbage, C. 2012. Financing Long-term Care in Europe. Palgrave Macmillan, London.Google Scholar
Davey, J., de Joux, V., Nana, G. and Arcus, J. 2004. Accommodation Options for Older People in New Zealand. New Zealand Institute for Research on Ageing, Wellington.Google Scholar
Finkelstein, A. and McGarry, K. 2006. Multiple dimensions of private information: evidence from the long-term care insurance market. American Economic Review, 96, 4, 938–58.Google Scholar
Fornero, E. and Monticone, C. 2011. Financial literacy and pension plan participation in Italy. Journal of Pension Economics and Finance, 10, 4, 547–64.Google Scholar
Frank, J. B. 2002. The Paradox of Ageing in Place in Assisted Living. Bergin & Garvey, London.Google Scholar
Friedemann, M. L., Newman, F. L., Seff, L. R. and Dunlop, B. D. 2004. Planning for long-term care: concept, definition and measurement. The Gerontologist, 44, 4, 520–30.Google Scholar
Gierveld, J. D. J., Dykstra, P. A. and Schenk, N. 2012. Living arrangements, intergenerational support types and older adult loneliness in Eastern and Western Europe. Demographic Research, 27, 167–99.Google Scholar
Gitlin, L. 2003. Conducting research on home environments: lessons learned and new directions. The Gerontologist, 43, 4, 628–37.Google Scholar
Gottlieb, A. S., Stoeckel, K. J. and Caro, F. G. 2009. Residential adjustment of elders: learning from experience with parents and peers. Journal of Housing for the Elderly, 23, 3, 149–65.Google Scholar
He, J. A. 2016. Public satisfaction with the health system and popular support for state involvement in an East Asian welfare regime: health policy legitimacy of Hong Kong. Social Policy and Administration. Published online November 4, 2016, doi:10.1111/spol.12274.Google Scholar
Henning-Smith, C. E. and Shippee, T. P. 2015. Expectations about future use of long-term services and supports vary by current living arrangement. Health Affairs, 34, 1, 3947.Google Scholar
Hong Kong Consumer Council 2015. Huge difference among residential care homes charge with various miscellaneous items. Choice, 467. Available online at https://www.consumer.org.hk/ws_en/news/press/elderlyhome_0915.html [Accessed 14 March 2017].Google Scholar
Inkmann, J., Lopes, P. and Michaelides, A. 2011. How deep is the annuity market participation puzzle? Review of Financial Studies, 24, 1, 279319.Google Scholar
Iwasaki, M., McCurry, S. M., Borson, S. and Jones, J. A. 2010. The future of financing for long-term care: the Own Your Future campaign. Journal of Aging and Social Policy, 22, 4, 379–93.Google Scholar
Keeling, S. 1999. Ageing in (a New Zealand) place: ethnography, policy and practice. Social Policy Journal of New Zealand, 13, 95114.Google Scholar
Kwong, E. W. Y. and Kwan, A. Y. H. 2001. A review of private residential care in Hong Kong: implications for policy and practice. Journal of Aging and Social Policy, 13, 4, 7389.Google Scholar
Lawler, K. 2001. Ageing in Place: Coordinating Housing and Health Care Provision for America's Growing Elderly Population. Joint Center for Housing Studies of Harvard University and Neighborhood Reinvestment Corporation, Washington DC.Google Scholar
Lee, S. Y. and Chou, K. L. 2016. Trends in elderly poverty in Hong Kong: a decomposition analysis. Social Indicators Research, 129, 2, 551–64.Google Scholar
Leung, E. M. F. 2001. Changing needs and changing service delivery for long-term care in Hong Kong. Journal of Ageing and Social Policy, 13, 2/3, 155–68.Google Scholar
LifePlans 2012. Who Buys Long-term Care Insurance in 2010–12? A Twenty Year Study of Buyers and Nonbuyers, 1990–2010. Available online at http://www.ahip.org/WhoBuysLTCInsurance2010-2011 [Accessed 8 March 2016].Google Scholar
Lou, W. Q. V., Chui, E. W. T., Leung, A. Y. M., Tang, K. L., Chi, I., Leung Wong, E. K. S. and Kang, C. W. 2009. A Study Investigating Factors That Affect Long Term Care Use in Hong Kong. Submitted to Food and Health Bureau, Hong Kong SAR Government, Hong Kong.Google Scholar
Lou, W. Q. V., Chui, E. W. T., Leung, A. Y. M., Tang, K. L, Chi, I., Leung Wong, E. K. S. and Kang, C. W. 2011. Factors affecting long-term care use in Hong Kong. Hong Kong Medical Journal, 17, supplement 3, 812.Google Scholar
Lusardi, A. and Mitchelli, O. S. 2007. Financial literacy and retirement preparedness: evidence and implications for financial education. Business Economics, 42, 1, 3544.Google Scholar
MetLife Mature Market Institute 2009. Boomer Bookends: Insights into the Oldest and Youngest Boomers. Metropolitan Life Insurance Company, New York. Available online at https://www.metlife.com/assets/cao/mmi/publications/studies/mmi-boomer-bookends.pdf [Accessed 15 March 2016].Google Scholar
NOP Roper Public Affairs and Media 2009. The Costs of Long-term Care: Public Perceptions Versus Reality in 2006. Available online at http://assets.aarp.org/rgcenter/health/ltc_costs_2006.pdf [Accessed 2 March 2016].Google Scholar
Quine, S. and Carter, S. 2006. Australian Baby Boomers’ expectations and plans for their old age. Australasian Journal on Aging, 25, 1, 38.Google Scholar
Ramesh, M. 2004. Social Policy in East and Southeast Asia: Education, Health, Housing and Income Maintenance. Routledge, London.Google Scholar
Research Office, Legislative Council 2015. Challenges of Population Ageing. Research Brief 1, Research Office, Legislative Council, Hong Kong SAR Government. Available online at http://www.legco.gov.hk/research-publications/english/1516rb01-challenges-of-population-ageing-20151215-e.pdf [Accessed 2 June 2016].Google Scholar
Robison, J., Shugrue, N., Fortinsky, R. H. and Gruman, C. 2014. Long-term supports and services planning for the future: implications from a statewide survey of baby boomers and older adults. The Gerontologist, 54, 2, 297313.Google Scholar
Ruggles, S. 2007. The decline of intergenerational coresidence in the United States, 1850–2000. American Sociological Review, 72, 6, 964–89.Google Scholar
San Antonio, P. M. and Rubinstein, R. L. 2004. Long-term care planning as a cultural system. Journal of Aging and Social Policy, 16, 2, 3548.Google Scholar
Shirasawa, M. 2015. Current situation and issues of the long-term care insurance system in Japan. Journal of Asian Public Policy, 8, 2, 230–42.Google Scholar
Siu, A. 2002. Hong Kong's Mandatory Provident Fund. Cato Journal, 22, 2, 317–32.Google Scholar
Sixsmith, A. and Sixsmith, J. 2008. Ageing in place in the United Kingdom. Ageing International, 32, 3, 219–35.Google Scholar
Social Welfare Department 2016. Waiting List and Waiting Time for Subsidised Residential Care Services for the Elderly. Social Welfare Department, Hong Kong SAR Government. Available online at http://www.swd.gov.hk/doc/elderly/ercs2/LTC%20statistics%20HP-Eng(201607).pdf [Accessed 23 June 2016].Google Scholar
Social Welfare Department 2017. Provision of Residential Care Services for Elders. Social Welfare Department, Hong Kong SAR Government. Available online at http://www.swd.gov.hk/doc/elderly/ERCS/3Overview%20item(a)english%2031-12-2016%20rev.pdf [Accessed 20 November 2016].Google Scholar
South China Morning Post 2015. Hong Kong elderly home faces loss of license after naked abuse scandal, 29 May.Google Scholar
Stum, M. S. 2008. Group long-term care insurance: decision-making factors and implications for financing long-term care. Journal of Aging and Social Policy, 20, 2, 165–81.Google Scholar
Tinker, A. 1997. Housing for elderly people. Reviews in Clinical Gerontology, 7, 2, 171–6.Google Scholar
World Health Organization 2007. Global Age-friendly Cities Project. Available online at www.who.int./ageing/age_friendly_cities_network [Accessed 23 June 2016].Google Scholar
United Nations Department of Economic and Social Affairs 2015. United Nations World Population Prospects. Available online at https://esa.un.org/unpd/wpp/Publications/Files/WPP2015_Volume-I_Comprehensive-Tables.pdf [Accessed 5 April 2016].Google Scholar
Yang, W., He, J. A., Fang, L. and Mossialos, E. 2016. Financing institutional long-term care for the elderly in China: a policy evaluation of new models. Health Policy and Planning, 31, 10, 1391–401.Google Scholar