Global Long Term Care Market Outlook, 2031

Market Drivers

• Unprecedented global demographic aging and rising care dependency: The world is experiencing the most rapid and widespread population aging in human history. By 2050, the global population aged 60 years and older will double to 2.1 billion, with the number of persons aged 80 years or older tripling to 426 million. This demographic transformation is driven by increasing life expectancy, declining fertility rates, and improvements in healthcare delivery. The share of people needing long-term care across OECD countries is expected to increase from 11.6% in 2020 to 14.1% by 2070, pushing public expenditure from 1.7% to 2.6% of GDP. Germany's care-dependent population nearly doubled from 3.0 million in 2015 to 5.7 million in 2023, with the proportion of the population requiring care rising from 3.21% to 6.24%. Japan's long-term care costs reached ¥14.3 trillion in fiscal 2025, approximately four times the level when the system was established, and are projected to reach ¥27.6 trillion by 2040. China's population aged 60 and above reached 323.38 million at the end of 2025, representing 23.0% of the total population. The prevalence of chronic conditions, cognitive impairment, and functional limitations among older persons creates sustained and intensifying demand for long-term care services across all care settings.
• Policy reforms and government investment in care infrastructure: Governments across all regions are implementing significant policy reforms to address the growing demand for long-term care. The WHO has released the consultation draft of the Global Standards for Long-Term Care – the first global framework of standards to guide the planning, delivery, monitoring and improvement of long-term care for older people, with standards across eight chapters including definitions and principles, home- and community-based care, facility-based care, support for unpaid carers, workforce, financing, governance, and quality monitoring. China's long-term care insurance system has expanded from 15 pilot cities in 2016 to 92 cities by the end of 2025, covering 308.55 million insured persons with cumulative fund spending exceeding 100 billion yuan, benefiting more than 3.3 million disabled individuals. The Chinese government issued guidelines in late March 2026 to expand the scheme nationwide by 2028. Australia implemented the new Aged Care Act and the Support at Home program on 1 November 2025, representing the most significant aged care reforms in decades. Brazil's National Care Policy, established by Law No. 15.069/2024, established the National Care Plan with 79 concrete actions across five strategic axes. Colombia's CONPES 4143, approved in February 2025, establishes a National Care Policy with 133 actions and an indicative budget of 25.6 trillion pesos over ten years. The UAE launched the National Framework for Healthy Ageing 2025–2031, developed in collaboration with the World Health Organization. These policy developments are reshaping the financing, delivery, and regulation of long-term care services across the globe.
• Shift toward home and community-based care: Across all regions, long-term care delivery is increasingly shifting from institutional facilities to home and community settings. In the United States, 87% of the 9.7 million Medicaid LTSS users in 2023 received services in home- and community-based settings. In Germany, 86.2% of care-dependent people lived in outpatient settings in 2023, with 9 out of 10 living in their own homes in 2025. In South Korea, home-based care accounted for 63.0% of total benefit payments at 10.1897 trillion won in 2025, growing by 10.3% compared to the 8.0% rise in institutional care. In Australia, the Support at Home program is designed to enable more people to age in place, with expansion to support 380,000 individuals by 2025-26. In China, the 14th Five-Year Plan period saw the cumulative construction of 570,000 home-based elderly care beds and the provision of 30 million home-based elderly care services. This trend is driven by beneficiary preference for aging in place, government policies promoting community-based care, and the relative cost-effectiveness of home care compared to institutional care. Across OECD countries, around one-sixth of all long-term care spending was used for professional care provision at home.

Market Challenges

• Critical global workforce shortages and caregiver crisis: The global long-term care sector faces a severe and intensifying workforce crisis that threatens the sustainability of care systems worldwide. The WHO projects a global shortfall of approximately 10 million health workers by 2030, with the most severe deficits concentrated in low- and lower-middle-income countries. The global nursing workforce gap between demand and supply was 6.2 million in 2020, currently stands at approximately 5.8 million, and is projected to decline to 4.1 million by 2030, though significant regional disparities persist. Europe's long-term care sector employs around 6.3 million people, yet there is already a massive shortfall of carers, and the sector will need more than 1.6 million extra long-term care workers by 2050 just to maintain today's level of support. Japan requires 2.4 million care workers but faces a shortage of 250,000, which is projected to expand to 570,000 by 2040. Australia needs nearly 120,000 more aged care staff by 2035/36. China faces a caregiver shortage exceeding 5 million, with 85%–95% concentrated in the home and community sector. India has only 5,000–6,000 trained caregivers despite its elderly population of 153 million. The ILO emphasises that long-term care is as much a workforce challenge as a demographic one, and without decent work, secure jobs and workforce planning, systems will not be sustainable. Low wages, limited career development opportunities, and physically demanding working conditions contribute to high turnover and recruitment challenges worldwide.
• Infrastructure deficits and capacity constraints: Despite significant investment, many countries across all regions face substantial infrastructure deficits relative to their aging populations. Spain requires over 100,000 additional care beds to align with EU standards, with bed provision at 7% compared to Germany's 16% and France's 12%. Sweden needs between 100,000 and 140,000 new senior housing units by 2034, with 112 municipalities already reporting deficits in special housing for the elderly. Australia had only 236,894 operational residential and flexible aged care places as of June 2025 an increase of just 917 places from the previous year while the population aged 85 and above reached 607,000 and is projected to reach one million by 2035. Japan's special nursing homes have 225,000 people on waiting lists as of April 2025. Canada could need an additional 199,000 long-term care beds by 2035, nearly doubling current capacity. Brazil has approximately 7,000 long-term care institutions serving around 160,000 residents just 0.5% of the population aged 60 and above. These infrastructure deficits create significant access barriers and quality challenges across the globe.
• Rising care costs and financial sustainability pressures: The cost of long-term care continues to rise across all regions, creating significant financial sustainability challenges for both governments and households. Japan's long-term care costs reached ¥14.3 trillion in fiscal 2025, about four times the level when the system was established, and are projected to reach ¥27.6 trillion by 2040. Germany's care insurance system faces a billion-euro deficit that is projected to rise from €3.5 billion in 2026 to more than €12 billion in 2029 under unchanged regulations. In the United States, the median annual cost of a private room in a skilled nursing facility exceeded $116,800 in 2023, while assisted living monthly costs average $5,419. In Canada, monthly assisted-living fees range from $2,565 to $4,030, a level 40% of older Canadians cannot meet without selling assets. In Italy, RSA monthly fees range from €1,800 to €4,500, with public long-term care spending declining from 1.43% of GDP in 2020 to 1.18% in 2024. In Mexico, the average monthly cost of care services for older adults is approximately 22,500 pesos, while the average household income is 25,955 pesos. These cost pressures are compounded by rising labour costs, regulatory compliance requirements, and limited public reimbursement rates in emerging markets.

Market Trends

• Technology adoption and digital transformation: Countries across all regions are increasingly adopting technology to address workforce shortages and improve care quality. The WHO's Global Standards for Long-Term Care include specific provisions for quality monitoring and workforce development, reflecting the growing recognition of technology's role in care delivery. Japan is promoting care robots and AI to reduce the physical burden on care workers. Australia's Support at Home program introduces quarterly budgets with limited rollover funding and separate funding pools for assistive technology and home modifications. China's 15th Five-Year Plan calls for integrating medical and eldercare services and establishing a unified system for assessing seniors' functional abilities. The UAE's National Framework for Healthy Ageing 2025–2031 includes the "Ambassadors of Healthy Ageing" programme, which recruits socially active, middle-aged individuals to serve as community advocates promoting positive health messages. In Brazil, the Ministry of Health's Home Care Program for the Elderly includes provisions for telehealth and remote monitoring. The EU-funded Care4Skills project is developing a roadmap for a stronger long-term care workforce, with the Pact for Skills aiming to train at least 3.8 million long-term care workers.
• Growth of private sector investment in senior living: Private sector investment in senior living and long-term care is growing across all regions, driven by favorable demographics and the recognition of long-term care as an investable asset class. In France, the top 15 EHPAD operators manage 108,000 beds, with the top five groups concentrating 85,600 beds. Spain's care bed capacity must increase from approximately 384,000 to around 616,000 by 2033 to meet projected needs. The UK care home market has attracted significant investor interest, with average EBITDARM margins growing four percentage points to 30.1% in 2025. China's private hospital sector has expanded rapidly, with approximately 26,000 private hospitals representing 68% of all hospitals. India's senior living market is projected to reach $14.14 billion by 2031, with the organised supply of senior citizen homes at 22,157 units as of June 2025. In Chile, 97% of long-term care establishments are private, with 55% for-profit and 42% non-profit. The "silver economy" is being recognised as a significant growth opportunity across both developed and developing economies.
• Expansion of community-based care models and integrated service delivery: The shift toward community-based care is accelerating across all regions, driven by beneficiary preference, government policies, and the relative cost-effectiveness of home care. China is building a three-tier urban-rural elderly care service network comprising county-level comprehensive platforms, township regional centres, and village-level facilities, with county-level public elderly care institutions covering 100% of counties and 20,500 township centres established. Colombia's Bogotá Communities of Care programme provides comprehensive care for more than 1,900 older adults through 20 Care Communities. Brazil's Belo Horizonte initiated services for the elderly at CRAS centres in 2025, accompanying more than 1,000 elderly people per year. Uruguay's National Care System is advancing toward universal coverage with the Third National Plan on Ageing and Old Age for 2025-2029. In South Africa, the National Policy Dialogue on Elder Care examined home-based care services as one of five key themes, recognising the need for stronger support for caregivers and community services. The convergence of government policy support, private sector investment, and technological innovation is creating the foundation for more comprehensive long-term care ecosystems across the globe.