National People's Congress Deputy Li Yan of Qilu Pharmaceutical Proposes Age-Friendly Healthcare and Inclusion of Palliative Care in Medical Insurance for China's 320 Million Elderly

Data from the National Bureau of Statistics shows that by the end of 2025, the population of people aged 60 and above in China will have climbed to 323 million, accounting for 23% of the total population. This means that approximately one in every five people will be elderly. It is projected that by 2035, this number will exceed 400 million, at which point China will officially enter a severely aging society. Against this backdrop, how to ensure that over 300 million elderly people enjoy their later years and continuously enhance their sense of health and well-being has become an important issue for the whole of society to address collectively.

At the 2026 National Two Sessions in China, Li Yan, a national representative and president of Qilu Pharmaceutical Group, presented the proposal "On Accelerating the Construction of an Integrated Medical-Pharmaceutical-Rehabilitation Service System to Effectively Enhance the Health Satisfaction of the Elderly." Through her research, she found that the elderly population generally faces issues such as multiple coexisting diseases, high incidence of chronic illnesses, and functional decline, leading to an increasing demand for integrated health services encompassing medical treatment, medication, rehabilitation, and nursing.

Li Yan pointed out that, although China has introduced a series of policies to promote the construction of elderly-friendly medical institutions and the integration of medical and elderly care, achieving phased results — 94.4% of public hospitals at or above the secondary level have set up "green channels" for the elderly, over 15,000 elderly-friendly medical institutions and 8,427 medical-elderly care integrated institutions have been established. However, compared with the growing needs of the elderly population and policy goals, the following shortcomings still exist in current practice.

Li Yan cited the "2024 Insight Report on the Needs for Micro-Transformations in Elder-Friendly Healthcare" in her proposal, pointing out that the complexity of hospital procedures is the primary pain point for the elderly, with over 90% of surveyed seniors requiring accompaniment during medical visits. Specific barriers are reflected in both the physical environment and digital services: In terms of the physical environment, common issues include small font sizes and low color contrast on directional signs, outdated accessible restroom facilities, and inconvenient wheelchair rentals. Regarding digital services, nearly 60% of surveyed elderly individuals called for hospitals to develop a "senior-friendly version" of their online systems, while nearly half of family members hope for a one-click medical consultation feature, reflecting that current smart healthcare solutions have yet to fully bridge the "digital divide" faced by older adults.

In response to this issue, Li Yan suggested establishing a multi-department collaborative supervision mechanism involving health, pharmaceutical regulation, civil affairs, and medical insurance sectors. This would continuously strengthen the dynamic supervision, evaluation, and rectification of senior-friendly medical institutions, while also working with the Ministry of Industry and Information Technology to guide hospitals in further advancing the adaptation of digital technologies for the elderly. This includes optimizing and upgrading features such as large fonts, large icons, elder mode, and barrier-free medical treatment.

Li Yan, National People's Congress Representative and President of Qilu Pharmaceutical Group. Image Source: Qilu Pharmaceutical Group

Moreover, there is a notable lack of medical devices and equipment specifically designed for the elderly in the market, with a low degree of alignment with actual clinical needs. Li Yan pointed out that the incidence of polypharmacy is high among elderly patients, with geriatric patients suffering from multiple diseases taking an average of 5.6 medications, and the potential risk rate of drug interactions reaching as high as 37%. However, less than 30% of hospitals across China have implemented standardized, systematic management programs for rational medication use.

To enhance the supply and adaptability of pharmaceuticals and medical devices for the elderly, Li Yan suggests strengthening the coordination mechanism between health authorities, drug regulators, and pharmaceutical companies. A platform should be established to connect clinical needs with research and development supply, guiding enterprises to increase investments in age-friendly developments such as easy-to-swallow formulations, portable testing equipment, and intelligent rehabilitation devices, while providing policy incentives. The evaluation standards and feedback mechanisms for clinical adaptability should also be improved, with medical institutions taking the lead in conducting clinical trials and effectiveness assessments, promptly feeding back to pharmaceutical companies to form a virtuous cycle of "demand-research-application-iteration."

In Li Yan's view, the poor coordination of the "medical-pharmaceutical-rehabilitation" mechanism leads to poor service continuity and structural imbalance in medical and elderly care resources. Specifically, the unified electronic health records for the elderly have not been fully integrated, resulting in the dilemma of "repeated referrals, duplicate examinations, and service interruptions" between hospitals, rehabilitation institutions, and communities, with a data interoperability rate of less than 30%.

Moreover, there is a significant structural imbalance on the service supply side, with a huge gap in professional talent; the shortage of elderly care workers is as high as 3.5 million. The regional distribution of medical and elderly care resources is uneven, with the coexistence of "a bed being hard to find" in big cities and a high vacancy rate of beds in third- and fourth-tier cities. Among these issues, hospice care services, which provide crucial support in the final stage of life, are particularly weak, with less than 0.4% of medical institutions in China having established a hospice care department.

In this regard, Li Yan suggested to further promote the construction of "Medical and Elderly Care Integrated System for Elderly Health Services". This would involve integrating resources from tertiary hospitals, secondary hospitals, community health service centers, rehabilitation institutions, and elderly care institutions within the region. The goal is to achieve unified management of electronic health records and enable cross-institutional and cross-level information sharing, addressing issues such as "frequent referrals, repeated examinations, and service gaps" for the elderly. This creates a closed-loop system where "minor illnesses are treated in the community, major illnesses are referred to hospitals, and rehabilitation takes place back in the community." At the same time, some secondary and lower-level medical institutions should be encouraged to transition into rehabilitation hospitals or nursing homes, ensuring the effective implementation of long-term prescription management for elderly patients with chronic diseases.

To address the shortcomings in end-of-life care, Li Yan suggested incorporating palliative care service capabilities as a key evaluation dimension in the construction of elder-friendly medical institutions. She proposed that hospitals at level two and above should gradually establish palliative care wards or zones. Efforts should be made to explore the inclusion of palliative care in medical insurance reimbursement, while encouraging participation from social forces to accelerate the filling of supply gaps.

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