South Korea reached the super-aged mark in December 2024, with over 20% of its population aged 65 and older. Eldercare jobs, labor-intensive and emotionally demanding yet accessible to low-skilled workers at low wages, are globally undesirable, leading to labor shortages in advanced economies. As baby boomers (born 1955-1963) enter the late elderly (75 and older) after 2030, demand for eldercare services is projected to surge, worsening supply-demand imbalances.

This study examines the current state and limitations of Korea’s eldercare workforce to propose policy improvements. It estimates eldercare labor supply and demand to forecast the scale of labor shortage and discusses strategies for workforce expansion. Additionally, an empirical analysis assesses how quantitative and qualitative workforce expansion impacts the quality of life for residents in long-term care facilities, providing policy insights.

Chapter 2 forecasts demand for eldercare services and estimates the eldercare labor supply to assess the scale of labor shortage and analyze supply-demand imbalances at the national and metropolitan/provincial levels. The findings indicate that the rapid rise in the super-aged population will sharply increase demand, outpacing the growth of care worker supply and deepening supply-demand imbalances. Regional variations in aging and available workforce are expected to widen the regional supply disparities, suggesting the need for proactive and region-specific workforce expansion policies. This chapter also estimates demand for services that reflect improvements in elderly health in the past decade, highlighting that workforce expansion alone is insufficient to resolve the supply-demand gap amid sustained demand growth. Managing demand for long-term care services through elderly health promotion and functional improvements is essential.

Chapter 3 investigates how expanding the eldercare workforce in long-term facilities affects health outcomes for care recipients. Using health insurance claims and long-term care insurance data, it examines the impact of the 2018 minimum wage increase and the 2022 staffing requirement changes on facility employment and recipients’ medical service utilization. The results indicate that workforce expansion is associated with reduced medical service use, leading to positive health outcomes, suggesting investment in care worker expansion can be a cost-effective policy measure.

Chapter 4 empirically analyzes the impact of enhancing nursing functions in eldercare workers on care recipients and discusses the need for improving their expertise. This chapter examines how changes in nursing staff skill composition following the 2018 minimum wage increase and the specialized nursing care unit pilot program launched in 2019 affected recipients' medical service utilization. The analysis shows that strengthening medical functions in long-term care facilities significantly reduces residents' use of high-cost inpatient services, leading to lower overall healthcare expenditures. While the increased costs of long-term care services partially offset these savings, the results suggest that the specialized nursing care unit program aligns with policy goals of optimizing healthcare utilization among facility residents.

Chapter 5 identifies the characteristics of foreign care workers using administrative data, albeit to a limited extent, aiming to enhance understanding of migrant labor in the eldercare sector. With restricted foreign worker employment in eldercare roles in Korea, this chapter assesses the potential impacts of their integration through existing literature. Furthermore, it reviews specific policy responses from countries utilizing migrant worker policies to mitigate eldercare labor shortages and discusses implications for Korea's eldercare sector.

Chapter 6 proposes future policy directions for eldercare workforce expansion based on the findings from the preceding chapters. First, quantitative workforce expansion enhances job quality, reduces workload through care technology, and utilizes migrant labor. Second, elevating the professional competence of the eldercare workforce involves strengthening nursing functions in long-term care facilities, clarifying the scope of nursing care that can be provided within such facilities, and enhancing education and training in geriatric medicine for facility staff. Third, managing care demand through health promotion entails implementing mental health and chronic disease management strategies to delay the need for eldercare. By addressing these areas, this study aims to contribute to the development of sustainable policies that ensure adequate workforce supply while improving the quality of eldercare services in Korea.

Preface
Summary

Chapter 1. Introduction
　References

Chapter 2. Current Status and Outlook for the Supply and Demand of Eldercare Workers
　Section 1. Introduction
　Section 2. Projections for Eldercare Service Supply and Demand
　Section 3. Conclusion
　References
　Appendix

Chapter 3. Effects of Expanding the Care Worker Workforce
　Section 1. Introduction
　Section 2. Analysis of Workforce Expansion Effects: Impact of the 2018 Minimum Wage Increase
　Section 3. Analysis of Changes in Staffing Requirements
　Section 4. Conclusion
　References
　Appendix

Chapter 4. Analysis of the Effects of Strengthening Nursing Functions in Long-Term Care Facilities
　Section 1. Introduction
　Section 2. Effects of Expanding Skilled Nursing Staff
　Section 3. Effects of Strengthening Nursing Functions in Long-Term Care Facilities: Specialized Nursing Care Unit Pilot Program
　References

Chapter 5. Foreign Care Workers and Immigration Policy
　Section 1. Introduction
　Section 2. Characteristics of Foreign Care Workers
　Section 3. Japan’s Policy Responses to Using Immigrant Labor in Eldercare
　Section 4. Conclusion
　References
　Appendix

Chapter 6. Policy Directions for the Eldercare Workforce
　Section 1. Policies for Quantitative Workforce Expansion
　Section 2. Strengthening Nursing Functions in Eldercare Services
　Section 3. Managing Eldercare Demand Through Older Adult Health Management
　References

Abstract