Growing Demand for Elderly Care

Speaking at the seminar entitled “Developing the Silver Economy – Constructing a Pillar for Sustainable Social Security”, jointly organized by the Journal of Economics and Finance (under the Ministry of Finance) and Ho Chi Minh City Social Security office on October 29, Dao Van Sinh, Specialist Level II Physician and Head of the Ministry of Health’s Representative Office in Ho Chi Minh City, noted that Vietnam had entered a demographic transition characterized by rapid population ageing from 2011 when the share of people aged 65 and over accounted for 7% of the total population. By 2021, this population group had reached approximately 8.16 million people, equivalent to 8.3% of the total population.

Dr. Huynh Minh Chin, Specialist Level II Physician and Deputy Director of the Ho Chi Minh City Department of Health, shared his views at the seminar.

In Ho Chi Minh City, this challenge is becoming increasingly evident. By the end of 2025, the city had approximately 1.57 million people aged 60 and above, accounting for nearly 11% of its population. The city entered the population ageing phase in 2017 and is forecasted to become an aged-population city by around 2038. Meanwhile, the total fertility rate in 2024 was only approximately 1.39 children per woman.

According to Dr. Chin, Deputy Director of the Ho Chi Minh City Department of Health, the challenge lies not only in the growing number of older people but also in their health conditions and care requirements. Many older people suffer from multiple chronic diseases simultaneously and face risks of reduced mobility, malnutrition, dementia or loss of self-care ability. These conditions require continuous coordination among hospitals, grassroots healthcare facilities, families and social assistance centres.

A major gap currently lies in the capacity to provide care services. Elderly care remains largely concentrated in hospitals and a number of inpatient care facilities, while home-based care, day- care, community-based rehabilitation and professional long-term care services have yet to develop commensurately. The city also faces a shortage of specialized personnel, including geriatric doctors, nurses, rehabilitation technicians and professionally trained caregivers.

The cost of long-term care may exceed the financial capacity of many families. In addition, dedicated financing mechanisms for long-term care remain limited, while coordination among hospitals, social assistance facilities, private service providers and families has yet to be organized under a unified process. These issues need to be addressed to expand access to quality care services.

Vietnam is entering a demographic transition at one of the fastest ageing rates in the world. Vietnam began its population ageing phase in 2011, when people aged 65 and above accounted for 7% of the total population. By 2021, this age group had reached approximately 8.16 million people, equivalent to 8.3% of the population.

According to projections, Vietnam will officially enter the aged-population phase in 2036, when people aged 65 and above are expected to account for 14% of the total population. By 2039, the number of older people is projected to increase to approximately 16.8 million, and is expected to reach 25.2 million by 2069.

It is necessary to prepare healthcare and social security systems to adapt to demographic changes. Older people often suffer from multiple illnesses, requiring long-term treatment, rehabilitation and assistance with daily activities. If the healthcare system continues to rely primarily on hospital-based medical examination and treatment, it will struggle to fully meet increasingly diverse care needs.

According to Sinh, the goal of elderly healthcare should not only be to extend life expectancy, but, more importantly, to prolong healthy life expectancy, maintain mobility and independence, and improve quality of life. This requires a shift from treatment to proactive disease prevention, from episodic care to continuous health management, and the simultaneous development of community-based care networks, home-based services and long-term care facilities.

In Ho Chi Minh City, this challenge is becoming increasingly evident. By the end of 2025, the city was expected to have approximately 1.57 million people aged 60 and above, accounting for nearly 11% of its population. The city entered the population ageing phase in 2017 and is forecasted to become an aged-population city by around 2038. Meanwhile, the total fertility rate in 2024 was only approximately 1.39 child/woman.

According to Dr. Huynh Minh Chin, Deputy Director of the Ho Chi Minh City Department of Health, the challenge lies not only in the growing number of older people but also in their health conditions and care needs. Many older people suffer from multiple chronic diseases simultaneously and face risks of reduced mobility, malnutrition, dementia or loss of the ability to care for themselves. These conditions require continuous coordination among hospitals, local healthcare facilities, families and social assistance establishments.

A major gap currently lies in the capacity to provide care services. Elderly care remains largely concentrated in inpatient hospitals and a number of inpatient facilities, while home-based care, day care, community-based rehabilitation and professional long-term care services have not yet been developed commensurately. The city also faces a shortage of specialized personnel, including geriatric doctors, nurses, rehabilitation technicians and professionally trained caregivers.

The cost of long-term care may exceed the financial capacity of many families. In addition, dedicated financing mechanisms for long-term care remain limited, while coordination among hospitals, social assistance establishments, private service providers and families has yet to be organized under a unified process. These issues need to be addressed to expand access to quality care services.

Speakers share their views on elderly healthcare (illustrative image)

Unlocking Resources for the Development of the Silver Economy

Population ageing not only increases demand for healthcare but also creates opportunities for the development of an entirely new service ecosystem. According to experts, the silver economy extends far beyond elderly care services. It encompasses healthcare, pharmaceuticals, assistive devices, healthcare technologies, rehabilitation, nutrition, insurance and a wide range of services catering to older people's daily needs. Within this ecosystem, healthcare plays a fundamental role.

Ho Chi Minh City has favorable conditions for developing this sector, thanks to its relatively well-developed network of medical examination and treatment facilities, experienced healthcare professionals, and diverse public and private healthcare institutions. The expanded development space following the administrative merger also creates opportunities to plan and develop long-term care facilities, rehabilitation centres, healthcare-integrated rehabilitation and service models tailored to different groups of the elderly.

However, this market potential can only become tangible opportunities if bottlenecks related to services, human resources and financing are addressed. According to Dr. Huynh Minh Chin, the Ho Chi Minh City Department of Health's development orientation is to mobilise additional resources from businesses, social organisations and the community to develop long-term care facilities, day care centres, home-based care services, rehabilitation services, assistive technologies and nutrition services.

Attracting investment must ensure with quality standards, supervision mechanisms and transparent information regarding costs, service coverage and the responsibilities of service providers. Care models should offer different service packages and price levels to ensure affordability, rather than allowing the market to focus exclusively on the high-end segment while leaving lower-income groups with limited access.

Alongside investment resources, financial mechanisms need to be further developed to support long-term care, rehabilitation and home-based care. Health insurance will continue to serve as a key pillar. At the same time, solutions on supplementary social insurance and financial savings mechanisms should be explored to help people proactively prepare for old age. Digital technologies and workforce training are also essential to improve service quality and ensure that the elderly receive continuous and safe care.

Developing the silver economy, therefore, is not only expanding the service market but also involves restructuring the care system to meet the actual needs of the elderly . When services are of high quality, affordable and widely accessible, new economic opportunities can go hand in hand with the goal of ensuring sustainable social security.