Seoul's Elderly 'Expeditionary Admissions' Strain Gyeonggi's Finances

Gyeonggi Province is facing a significant financial strain due to a surge in elderly welfare recipients relocating from Seoul to enter nursing homes within the province. This trend, dubbed 'expeditionary admissions,' is driven by the scarcity of suitable facilities in Seoul and the concentration of nursing homes in Gyeonggi, particularly in the northern areas where property prices are lower. As of December 2025, Gyeonggi Province hosts 1,688 nursing homes, representing 36.1% of the national total, far exceeding Seoul's 233 facilities.

The issue is exacerbated by the national funding system for long-term care. While the national government covers 80% of medical aid costs for hospitalized recipients, this support completely ceases once a recipient is admitted to a nursing home or receives home care benefits. The entire financial responsibility then falls on local governments, with Gyeonggi Province and its constituent cities bearing the full cost. This amounts to approximately 32.4 million won per recipient annually, leading to a projected 930.1 billion won in long-term care expenses for Gyeonggi Province in 2024, a substantial increase from previous years.

Local officials point to structural problems, such as Seoul's high real estate prices making it difficult to establish facilities that require direct ownership of land and buildings, as mandated by the Elderly Welfare Act. This pushes demand towards Gyeonggi's more affordable northern regions like Goyang and Namyangju. The influx of recipients from other regions, particularly Seoul, is creating a significant imbalance, with Gyeonggi shouldering care demands and financial burdens that arguably should be shared more broadly or supported by national funds.

To mitigate the financial pressure, some Gyeonggi cities, like Yangju and Goyang, have implemented measures such as total quantity control for long-term care institutions through local ordinances. This effectively raises the barrier to entry for new facilities, aiming to reduce the number of incoming residents from outside the province. However, critics argue that this approach may hinder access to care for vulnerable populations and shifts the burden rather than solving the systemic issue of national funding for long-term care.

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Due to the high real estate prices in Seoul, it is difficult to meet the nursing home facility requirements that mandate direct ownership of land and buildings according to the Elderly Welfare Act. As a result, a structural problem arises where demand from Seoul facilities is naturally concentrated in the northern Gyeonggi region.