This dissertation starts with the development and validation of the Taiwan Future Elderly Model (TFEM), the first microsimulation model for aging and health in Taiwan. Adapted from the US Future Elderly Model framework and utilizing Taiwan Longitudinal Study on Aging data, TFEM performs best for hearing loss, activities of daily living limitations, and dementia.
In the final chapter, I apply TFEM to project the future Taiwanese population with dementia and/or care needs, along with associated long-term care policy implications. Findings indicate a projected 50% increase in the living dementia population from 2023 to 2043. More notably, the population with care needs or severe care needs is expected to grow by approximately 90% and 150%, respectively. Assuming static care preferences, the model predicts a necessary doubling of Taiwan's formal long-term care capacity by 2043 compared to 2023 levels.
The research further explores interventions targeting diabetes incidence and hearing loss. Results suggest that a combined approach of reducing diabetes and hearing loss incidence, coupled with improved hearing aid utilization among individuals aged 50 and older, would be most effective in decreasing the dementia and care-needing population. However, the impact of these interventions on reducing required long-term care capacity is limited, highlighting the urgency of proactive policy measures to expand formal long-term care capacity in Taiwan.
This document was submitted as a dissertation in July 2024 in partial fulfillment of the requirements of the doctoral degree in Public Policy Analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Roland Sturm (Chair), Bryan Tysinger, and Pei-Jung Lin.
This publication is part of the RAND dissertation series. Dissertations are written by Ph.D. candidates at the RAND School of Public Policy and supervised, reviewed, and approved by a RAND School faculty committee overseeing each dissertation. The RAND School is the world's leading producer of Ph.D.'s in policy analysis.
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