About 32.6% of older adults aged 60 years and above in China had in 2018, but only 18.5% utilized home and community care services.
Limited mobility, age, income level, region, self-assessed health, and depression are associated with the utilization of home and community care services.
The highest single service utilization rate was for regular physical examinations at 15.5%.
Inequity in service utilization was notably influenced by income, contributing over 60% to the concentration indices for any type of service and regular physical examinations.
Intraregional factors accounted for about 90% of the inequity observed in utilizing any type of service.
Pro-rich inequities in service utilization indicate that those with higher income are more likely to access needed services.
Simplified
BACKGROUND: This study aimed to analyze the needs and utilization of the home and community integrated healthcare and daily care services ("home and community care services" for short) among older adults in China and to investigate the inequity in services utilization.
METHODS: Cross-sectional data were obtained from the 2018 China Health and Retirement Longitudinal Study. Needs and utilization rates of the home and community care services in older adults of 60 years old and above were analyzed. Binary logistic regression analysis was performed to explore the factors associated with services utilization among older adults with . Concentration index, horizontal inequity index, and Theil index were used to analyze inequity in services utilization. Decomposition analyses of inequity indices were conducted to explain the contribution of different factors to the observed inequity.
RESULTS: About 32.6% of older adults aged 60 years old and above had limited mobility in China in 2018, but only 18.5% of them used the home and community care services. Among the single service utilization, the highest using rate (15.5%) was from regular physical examination. Limited mobility, age group, income level, region, self-assessed health, and depression were statistically significant factors associated with utilization of any one type of the services. Concentration indices of any one type service utilization and regular physical examination utilization were both above 0.1, and the contribution of income to inequity were both over 60%. Intraregional factor contributed to about 90% inequity of utilizing any one type service, regular physical examination and onsite visit.
CONCLUSIONS: This current study showed that older adults with needs of home and community care services underused the services. Pro-rich inequities in services utilization were identified and income was the largest source of inequity. The difference of the home and community care service utilization was great among provinces but minor across regions. Policies to optimize resources allocation related to the home and community care services are needed to better satisfy the needs of older adults with limited mobility, especially in the low-income group and the central region.
Key numbers
18.5%
Utilization Rate
Percentage of older adults with using home and community care services.
32.6%
Prevalence
Proportion of older adults aged 60 and above with .
60%
Income Contribution to Inequity
Percentage contribution of income to inequity in home and community care services utilization.
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