I、 China's aging population

1. Population aged over 65 and its proportion

In recent years, China's aging population has been increasing and accelerating. According to the data of the seventh census, the population over the age of 65 has reached 190.64 million in 2020, with a year-on-year growth rate of 8.3%, far exceeding the 3.5% in 2012.According to the definition standard of the United Nations, when the proportion of the population aged 65 and over in a country or region exceeds 7% of the total population, it means that the whole country or region has entered an "aging society";When the proportion reaches 14%, we will enter a "deep aging society".In 2020, China's population aged over 65 has accounted for 13.5% of the total population, an increase of 4.4pp compared with 2011. According to the prediction of China development foundation, the proportion of China's elderly aged 65 and over will exceed 14% in 2022, which means that China is about to enter a "deep aging society".

2. Support pressure of elderly population

Due to the aggravation of the aging problem, the dependency ratio of the elderly (over 65 years old) in China increased year by year from 2015 to 2020.In 2020, every 100 people of working age need to support 19.7 people over the age of 65.The elderly dependency ratio is high and the upward trend has not changed. Urban families, especially double working families and single parent families, are facing severe support difficulties.The rapid popularization of the pension industry, including pension institutions, is expected to effectively alleviate this dilemma.

3. Elderly people living alone and empty nests

According to the results of the fourth sampling survey on the living conditions of the elderly in urban and rural China conducted by the national Aging office, there are about 40.63 million disabled and semi disabled elderly people in China, accounting for 18.3% of the elderly population.According to the national plan for the development of the cause of aging and the construction of the elderly care system in the 13th five year plan, the elderly population will increase to 29 million in 2020, and the elderly living alone and empty nests will increase to 118 million. The situation of population aging is grim.The home-based health care of the disabled, living alone and empty nest elderly is a key problem in the construction of elderly care welfare in China, which is also the source of great demand for the continued development of elderly care institutions in China.

II、 Current situation of pension industry

（1） Policy status

1.In terms of policy orientation, from a single emphasis on the development of the cause of aging to the coordinated development of the cause of aging and industry

Since the 18th National Congress of the Communist Party of China, there has been an obvious change in the orientation of the elderly care service policy, from the development of the cause of aging to the development of both the cause of aging and the industry.

Before the 18th National Congress of the Communist Party of China, the policies on promoting the development of elderly care services were basically carried out under the framework of the cause of aging.For example, in the process of the 12th Five Year Plan, the relevant planning contents on elderly care services were included in the 12th Five Year Plan for the development of China's aging cause issued by the State Council in 2011.

By the time of the 13th five year plan, the name of the plan on elderly care services was changed to the 13th five year plan for the development of national elderly care undertakings and the construction of elderly care system. This revision shows that the elderly care undertakings can not fully cover the content of elderly care services, and there are industrial development issues beyond the undertakings.

At the 19th national congress held in october2017, it was further emphasized that "we should actively respond to the aging population, build a policy system and social environment for the elderly, filial piety and respect for the elderly, promote the combination of medical care and elderly care, and accelerate the development of aging undertakings and industries."

These major policy signals show that, from the perspective of policy positioning, the elderly care service is no longer just a category within the cause of aging, but includes both undertakings and industries.The change of policy orientation means not only the enrichment of policy content, but also the expansion of policy influence.

As a result of this change, policies were intensively introduced during this period, which clearly emphasized the multi-level nature of elderly care services, the diversity of supply subjects and the diversity of supply methods.The Fifth Plenary Session of the 19th CPC Central Committee further emphasized "promoting the coordinated development of the elderly care cause and the elderly care industry", which not only requires equal attention to the elderly care cause and industry, but also requires mutual coordination and coordinated development.

2.In terms of policy objectives, the key groups should be transformed into basic services

After the policy orientation was changed to the development of aging undertakings and industries, the coverage of pension services was also significantly expanded, from key groups to all the elderly, and the content of security was gradually defined as basic pension services, realizing the transformation from key groups to basic services.

From the principle of "adhering to the basic security" in 2013 and "ensuring that everyone has access to basic elderly care services" to the "ensuring that everyone has access to basic elderly care services by 2022" in 2019, it reflects that the policy objective of elderly care services has been transferred to the basic security services.

The Fifth Plenary Session of the 19th Central Committee clearly required that "we should improve the basic elderly care service system, develop inclusive elderly care services and mutual aid elderly care," and once again defined the basic policy objectives of ensuring basic services.

3.In terms of policy focus, the focus has changed from supporting institutions to promoting coordination between home-based community institutions

Before the 18th National Congress of the Communist Party of China, the main supporting policies basically focused on institutional elderly care, and there was little specific policy support for giving play to the basic role of home-based elderly care and developing community elderly care services.Since the 18th National Congress of the Communist Party of China, this situation has gradually improved. In the process of promoting the supply side structural reform of the national economy, making up for weaknesses has become an important part of the structural reform. As an obvious weakness in the supply side of elderly care services, community elderly care services have received great attention.

The policy focus has not only focused on supporting the construction and operation of elderly care institutions, but also on the coordinated development of the entire elderly care service system. While developing elderly care institutions, we must also vigorously develop community elderly care services to create good conditions for home-based elderly care.In the report of the fourth and fifth plenary sessions of the 19th Central Committee, the construction of the elderly care service system was clearly described as "coordination between home-based community institutions", which also provided clear guidance for future policy priorities.

4.In terms of policy content, from the old-age care theory to promoting the combination of medical care and health care

Since the 18th National Congress of the Communist Party of China, the relevant policy departments have been deeply aware of the importance of the combination of medical care and nursing care, and have continuously introduced measures to promote the combination of medical care and nursing care, from top-level design to simplifying the registration and approval procedures of the combination of medical care and nursing care institutions to pilot demonstration, gradually promoting the combination of medical care and nursing care to reality.At the same time, the combination of medical care and nursing care has been added to the social elderly care service system.

The Fourth Plenary Session of the 19th CPC Central Committee further enriched "the combination of medical care and health care" into "the combination of medical care and health care", and proposed "actively respond to the aging population, and accelerate the construction of an elderly care service system that integrates home-based community institutions and medical care and health care."The Fifth Plenary Session of the 19th Central Committee once again emphasized "building an elderly care service system that integrates home-based community institutions and medical care and health care".

These important spirits show that the content of the policy has changed from the old-age care to the promotion of the combination of medical care and health care, which reflects that the vision of the formulation of the old-age service policy is broader and is no longer limited to the old-age service itself, but extends to the old-age care and the medical and health services that affect its quality, reflecting the systematic thinking and problem awareness.

（二）. 养老机构现状

1. Number of elderly care institutions

In recent years, with the rapid aging of China's population, there has been a huge demand for elderly care services, which has accelerated the development of China's nursing home industry.From 2015 to 2020, the number of elderly care institutions in China showed an overall growth trend.After 2019, with the accelerated growth of the elderly population and the announcement of the new measures for the management of elderly care institutions, the elderly care institutions industry has entered a state of rapid growth. The growth rate of the number and scale in 2019 and 2020 is higher than 10%. By the first quarter of 2021, there were 38670 elderly care institutions in China.

2. Number of beds in elderly care institutions

From 2015 to 2020, the number of beds in China's elderly care institutions increased year by year.According to the data released by the Ministry of civil affairs, there were 4.831 million beds in elderly care institutions nationwide in 2020, a year-on-year increase of 12.6%, reaching a new high in recent years. By the first quarter of 2021, there were 4.918 million beds in elderly care institutions nationwide.

From an average perspective, in 2020, the number of elderly care beds per thousand elderly people in China reached 25.3, up 22.8% from 20.6 in 2012, but lower than that in 2014. This shows that with the acceleration of aging in recent years, the growth rate of elderly care beds can not keep up with the growth rate of the elderly population, and the supply of elderly care beds still needs to be accelerated.From an international perspective, developed countries in Europe and the United States generally have a high number of elderly care beds per thousand elderly people, but with the intensification of the aging situation, the average number of beds has a general downward trend;The number of elderly care beds per thousand elderly people in China, Japan and South Korea is similar, and there is no obvious downward trend, but there is a large gap with European and American countries, and there is a large room for growth.

（3） Problems of elderly care institutions

1. Occupancy rate of elderly care institutions

In recent years, the demand for elderly care services in China has increased rapidly. According to the fourth sampling survey on the living conditions of urban and rural elderly in China released by the national office for the aged in 2015, the proportion of urban and rural elderly self-reported needing care in China was 15.3%, up 1.6% from 13.7% in 2010 and 9.1% from 6.6% in 2000.In the face of the rapidly growing demand for elderly care services, the occupancy rate of nursing homes in China is not high.On july29,2020, the Ministry of Civil Affairs held a regular press conference in the third quarter of 2020, announcing that China has built 4.291 million beds in elderly care institutions, and 2.146 million elderly people are living in them. The vacancy rate of elderly care beds is as high as 50%.

2. Cause analysis

The high vacancy rate of nursing homes is greatly influenced by the traditional concept of providing for the aged.In China, the vast majority of the elderly still choose to provide for the aged at home, because in China, the family is the responsibility of their children or other relatives.Although the burden of children or relatives increases, on the other hand, paying the satisfaction brought by family affection, increasing family cohesion and inheriting memory are also the embodiment of ordinary people's happiness.

In addition to the traditional concept of elderly care restricting the improvement of the occupancy rate of nursing homes in China, the more significant reason is the uneven quality of elderly care institutions in China: some elderly care institutions have problems such as insufficient professional nursing talents, unreasonable location and pricing, imperfect service facilities and so on.According to the different groups targeted by the project, China's current elderly care service institutions can be divided into three categories: high-end, medium and high-end and medium and low-end customers. Among them, the occupancy rate of medium and low-end elderly care institutions charging less than 3000 yuan per month is more than 50%. There are a large number of such institutions, but the equipment is not complete and there are few nursing staff;The occupancy rate of medium and high-end elderly care institutions charging 4000-8000 per month is mostly more than 90%; -->