Operating beyond the super-aged threshold, Korea faces deepening shortages in its eldercare workforce as the sector struggles to attract workers. While better job quality is imperative to expand this workforce and maintain the quality of life for older adults, incentives for domestic workers alone will not close the gap. Visa policy needs to change to bring in foreign care workers, and care robot technologies should be actively deployed to raise labor productivity in the sector. - Demand for formal eldercare services is expected to rise sharply, with workforce shortages deepening in step. - Demand for LTC services is projected to increase by more than 2.4 times between 2023 and 2043. - Health improvements offset demand only modestly. The growing 85+ population will drive faster growth in high-intensity care (Grades 1？3). - The supply of LTC workers is projected to peak at 806,000 in 2034 before declining. - The share of care workers aged 60 and over is expected to rise from 63.1% in 2023 to 72.6% in 2043, reflecting an increasingly aged workforce. - Holding the 2023 caseload per care worker constant would require an additional 990,000 workers by 2043. - Differences in the pace of aging across regions will widen disparities in the number of beneficiaries per care worker. - Foreign care workers comprised just 0.9% of the total workforce in 2023, a marginal presence in the sector. - With 56.6% of foreign care workers aged 60 or over and 77% concentrated in the SMA, their capacity to mitigate workforce aging and regional supply disparities remains highly constrained. - Visa policy for foreign care workers should shift to occupation-specific visas with managed aggregate inflows, guided by the extent to which better job quality can expand the domestic workforce. - Applying current EPS service-sector quotas to care facilities would permit up to 63,000 foreign workers. - The E-7 care worker visa pilot should be expanded in scale, alongside efforts to secure sufficient enrollment for the associated training program. - Attracting domestic workers and retaining recruited foreign careworkers both require better job quality. - Targeted incentives are needed to encourage employment in underserved regions and ease supply-demand imbalances. - Care robot uptake in Korea remains low, with just 6.4% of surveyed facilities deploying them. - The main reason for deploying care robots is to ease the physical burden on care workers; adopters report workload reductions of more than half in some cases. - Cost is a key barrier to adoption: 51.8% of care facilities would deploy care robots if cost subsidies were provided. - Care robot policy should expand beyond its developer-centered focus to include support for care facilities, promoting wider adoption in frontline care settings.

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.