As population ageing intensifies and economic growth shifts firmly toward high-quality development, the principle of “investing in people” has come to the forefront. Against this backdrop, the elderly care industry and pension finance have become pivotal fields for implementing the national strategy on population ageing, balancing livelihood security and economic progress.
As a core research priority under HKAII’s Greater Health track, we have officially launched a series of seminars and exchanges on the elderly care industry and pension finance starting this year. Focusing on key industry challenges, our interdisciplinary and comparative research emphasizes forward-looking insights, practical operability and long-term sustainability, delivering theoretical support and actionable references for the high-quality development of the elderly care sector.
On 19 March 2026, the First Seminar and Project Launch of the Elderly Care Industry & Pension Finance Series, hosted by the Hong Kong Academy of Industry and Innovation (HKAII) and organized by the Shanghai Guoyan Wealth Management Research Institute, was successfully held in Shanghai. Yang Fan, Associate Professor at the School of International and Public Affairs, Shanghai Jiao Tong University, and Zhu Haiyang, Deputy Director of the Technology Committee of the China Ageing Industry Association & HKAII Industry Research Fellow, delivered keynote speeches on the development of elderly care services, smart elderly care practices and pension financial innovation respectively. Below is the curated summary of core insights shared at the event.
Professor Yang established a four-tier analytical framework — silver economy, elderly care industry, health & wellness industry, and nursing care industry — to systematically define the overall scope, hierarchical boundaries and core logic of elderly-related economic activities.
He explained that these sectors follow a clear structure from broad to specialized:The silver economy covers the full spectrum of economic activities for the elderly with the widest definition; the elderly care industry follows official national statistical classifications and focuses on basic livelihood security; the health & wellness sector prioritizes physical and mental well-being; while the nursing care industry delivers rigid, professional services for disabled and semi-disabled seniors, featuring the clearest boundaries, most essential demand and highest service integration — forming the cornerstone of the entire elderly care system.
Based on this framework, Professor Yang focused on the development logic, practical dilemmas and solutions for China’s nursing care sector. He stressed that discussions on ageing should move beyond the broad concept of the silver economy and center firmly on nursing care, as the overall quality and resilience of the elderly care system ultimately depend on the supply of professional care capacity. Compared with the loosely defined silver economy, nursing care targets clearer groups, scenarios and needs with higher service integration, making it the most critical yet challenging segment of the ecosystem.
He particularly emphasized that the core importance of nursing care stems not only from the growing elderly population, but also from the gap between overall life expectancy and healthy life expectancy. A 2024 study covering 183 WHO member states revealed a widening global gap — a trend also evident in China. As lifespans extend, more seniors face prolonged periods of disability, semi-disability or chronic illness in later life. Longer life expectancy does not equate to better quality of life; it may instead increase care burdens, family pressure and risks such as poverty in old age. A resilient nursing care industry therefore underpins stable social operations in a super-ageing society, beyond merely supplementing elderly services.
In analyzing current challenges, Professor Yang identified three prominent bottlenecks in China’s care sector:First, poor profitability. Research from Shanghai Jiao Tong University’s Industry Institute shows that one-third of care enterprises operate on slim margins, one-third break even, and one-third sustain losses. Low occupancy rates, unstable payment habits among residents and insufficient long-term affordability hinder the formation of a sustainable commercial model.Second, a unified national market remains absent, marked by severe regional fragmentation and inconsistent service standards.Third, critical workforce shortages persist, including frontline nursing staff and management talent, directly undermining service quality and industrial scalability.
He further noted these issues reflect structural developmental contradictions rather than weak corporate operations alone. Although China has entered an ageing society, its population is “not yet old enough” to fully release high-intensity care demand. Data shows those aged over 80 account for only 2.80% of China’s total population, compared with 7.54% in Germany and 10.57% in Japan. Among residents aged 60 and above, the proportion of those over 80 stands at 12.23% in China, far lower than 24.32% in Germany and 29.42% in Japan. With family care capacity still largely intact, demand for institutional professional care remains suppressed, resulting in oversupply of facilities without stable payment inflows. This situation will shift rapidly as the advanced-age population peaks in the future; insufficient preparedness today will lead to severe supply shortages tomorrow.
On financial security, Professor Yang argued that long-term reliance on private self-payment is unsustainable. Full dependence on family and personal spending cannot support stable industrial growth. Globally, long-term care security adopts tax-funded models, dedicated long-term care insurance, social assistance or hybrid multi-pillar frameworks. China remains in a transitional phase from regional pilots to nationwide institutionalization, requiring a stable, sustainable long-term care funding system to shift care expenditure from sporadic private payments to structured public mechanisms — a critical step for industrial stability.
Regarding Japan’s Long-Term Care Insurance System, Professor Yang offered a prudent evaluation. He acknowledged its benchmark design: an independent specialized care security scheme separate from medical insurance and pensions, funded via a 1:1 ratio between insurance premiums and public finance on a pay-as-you-go basis, supplemented by personal co-payments. However, Japan’s experience also highlights systemic risks amid deepening super-ageing: total annual expenditure surged from JPY 3.6 trillion at launch to JPY 14.3 trillion by 2025, far outpacing fiscal and premium revenue growth. Average monthly premiums for eligible contributors aged 40–64 nearly tripled, while the ratio of contributors to beneficiaries deteriorated from 3.3:1 to 1.8:1. In 2025 alone, 430,000 seniors aged over 75 became “care refugees” unable to access essential services, shifting care pressure back onto families, increasing care-related resignations and suppressing overall labor productivity and economic performance. China must avoid direct replication and tailor reforms according to demographic shifts, fiscal capacity and traditional family care norms.
On smart elderly care, Professor Yang opposed simplistic perceptions of “robot replacement for human caregivers”. In his view, genuine value lies in digitizing perception, early warning, collaboration and record-keeping throughout care workflows via IoT, big data and AI — empowering nursing staff, optimizing processes and reducing management costs, rather than pursuing fully unmanned operations. He advocated a “digital-intelligent & embodied integration” model, where technology supports caregivers, managers and families in risk detection, precise care delivery and efficient collaboration.
Based on field research at smart elderly care facilities, he summarized four core application scenarios:
He emphasized that smart elderly care must move beyond mere hardware deployment or conceptual showcases. The key breakthrough lies in transforming fragmented, experience-based and non-priced care activities into standardized, recordable, evaluable and billable service units, aligning digital protocols with professional care standards. This creates clear payment foundations and enables integration with insurance mechanisms, government procurement and socialized funding.
In summary, Professor Yang concluded: the nursing care industry represents the toughest yet most critical segment of the silver economy. China faces dual dynamics — currently suppressed demand alongside explosive future growth. Resolving poor profitability, supply imbalances and workforce shortages requires coordinated progress in establishing long-term care financial security, proactive health intervention and deep integration between digital technology and care standardization. Ageing is ultimately a systemic challenge covering talent, funding and resources; the maturity of China’s nursing care sector defines the nation’s true capacity to manage a super-ageing society.
Dr. Zhu Haiyang’s presentation focused on policy frameworks, industrial status, market opportunities and pension financial innovation, addressing key questions on future development directions, growth drivers and new operational models for China’s elderly care sector. His core judgment: amid deepening population ageing, the industry has entered a new phase of strengthened policy support, gradual demand release and accelerated industrial integration. Future development must balance the people’s livelihood nature of elderly services with its potential as a new growth engine.
On policy context, Dr. Zhu noted that China’s population aged 60 and above reached 310 million by the end of 2024, accounting for approximately 22% of the total population. Ageing has evolved from a marginal social issue into a macro factor shaping economic operations and public resource allocation, driving a fundamental shift in national elderly care policy logic. Policies have expanded from basic social assistance for vulnerable groups to a core component of the national strategy for active ageing, targeting a multi-tiered system covering safety nets, universal services and diversified provisions to realize comprehensive well-being for the elderly in livelihood, healthcare, education, social participation and leisure. Relevant national policy guidelines further reinforce this systemic transformation from traditional welfare to integrated public services, industrial development and social governance.
Dr. Zhu outlined four key policy priorities:
On industrial performance, Dr. Zhu shared systematic data insights: China hosts 17.7277 million registered elderly care enterprises (up 19.64% year-on-year), with total registered capital of RMB 135.91 trillion (up 10.79%) and 48.61 million social security contributors (up 10.19%). Annual net enterprise growth reaches approximately 400,000 despite intensified market competition, confirming continuous industrial expansion. However, the sector remains dominated by micro-enterprises: 92.63% employ fewer than five staff, while large-scale branded chains remain scarce. Most enterprises are newly established, reflecting rapid industrial incubation with limited mature leading players. Domestic private capital dominates, with foreign investment accounting for merely 0.87%, highlighting reliance on local institutional environments, domestic demand and indigenous innovation — requiring targeted policy support for private enterprises on financing, land access, standardization, regulation and talent recruitment.
In terms of service delivery, community elderly care centers and meal assistance outlets far outnumber formal care institutions, solidifying the model of home-based care as the foundation, community support as the backbone and institutional care as supplementary. Public-built privately-operated facilities have grown rapidly, integrating government asset resources with professional socialized operations as a core developmental pathway. Future expansion should prioritize diversified asset-light service models rather than over-reliance on heavy institutional construction.
Dr. Zhu emphasized rapid growth in elderly care technology and smart services, which account for 30.6% of all industry enterprises, alongside elderly product manufacturing at 27.6%. Megacities including Shanghai demonstrate clear advantages in technological integration, capital aggregation and innovative business models, with higher average registered capital per enterprise than the national average.
On market opportunities, future elderly demand will expand beyond basic daily care to multi-tiered needs including health management, rehabilitation, spiritual well-being and social participation. Improved payment capacity will drive growth in home-based services, rehabilitation centers, retirement tourism and elderly education. Deepened application of AI, IoT, cloud computing and big data will create new product and service scenarios, while industrial integration with healthcare, tourism, education and culture will foster hybrid business formats.
On development recommendations, Dr. Zhu stressed balanced progress on supply expansion and standardized regulation: optimizing fiscal, tax and financial support to attract social capital while strengthening service standards and regulatory oversight to prevent fraud and malpractice, building a trustworthy consumption environment for elderly families. Industry associations should also play a stronger role in standard formulation and cross-enterprise collaboration.
On pension financial innovation, he proposed systemic reforms aligned with industrial needs: expanding the third pillar of pensions via wider enterprise annuity and personal pension coverage with automatic enrollment mechanisms; improving connectivity between the second and third pillar personal accounts; integrating pension funds with housing provident fund accounts to optimize capital allocation; introducing international models such as the UK NEST scheme to build default investment platforms with simple, transparent pension products for ordinary investors; launching pension strategy index products with clearer returns; relaxing investment restrictions for occupational pensions; and enhancing investor education to improve public financial literacy. These measures aim to mobilize pension capital for long-term, secure investment supporting both personal retirement planning and industrial growth.
Dr. Zhu highlighted family-oriented financial innovations tailored to Chinese social norms, proposing a joint household account model: accounts owned by elderly parents with assisted management rights for children, enabling structured low-risk wealth allocation for family support funds such as living allowances and festival subsidies. This formalizes informal intergenerational care arrangements to improve capital efficiency and financial stability for seniors.
He also introduced an innovative fiduciary service platform model: professional institutions aggregate continuous, fragmented elderly demand across care, medical treatment, wellness and product procurement, converting decentralized needs into bulk orders via big data resource allocation. The platform connects care facilities, medical providers and suppliers to deliver integrated one-stop services, reducing household costs while enhancing operational efficiency for enterprises — creating a scalable, asset-light and sustainable commercial pathway for the sector.
In conclusion, Dr. Zhu summarized: China’s elderly care industry has entered an era driven by both policy and market forces. Future progress depends not only on expanding supply volume, but also on optimizing structural alignment and strengthening industry-finance collaboration. Integrated development between elderly services, care technology and pension finance can address real elderly needs while unlocking growth potential via institutional, platform and product innovation. The next phase requires solidifying service delivery, establishing robust payment systems, scaling platform models and deploying targeted financial tools to achieve long-term sustainable industrial development.
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