Does the Implementation of Home-based Care Service Policy Improve the Quality of Life for the Elderly? Evidence from 28 Provinces in China

Abstract

Purpose: To evaluate the policy treatment effects of home-based care service scientifically and identify the key intervention groups of home-based care services accurately in China. Methods: The data set was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2018. The elderly over 60 years old were selected as the study subjects. The factors analysis method was used to construct the evaluation index of the quality of life (QoL). The ordinary least squares (OLS) model and the propensity score matching (PSM) method were adopted to analyze the impact and heterogeneity of home-based care services on the QoL. The substitution variable method and the change measurement model method were chosen to test the stability of the model. Results: (1) From the perspective of the utilization rate of home-based care services, the utilization rate of home-based care services were generally low in China. The utilization rate of medical services was 23.37, whereas the life care service was 3.64%. Moreover, there was a serious regional imbalance in China. (2) From the point of view of the policy treatment effects of home-based care service, it had a positive policy effect on the QoL of the elderly. The intervention effect of medical care service on QoL was 0.030 standard points and the life care service on QoL was 0.034 standard points. (3) The heterogeneity test showed that medical care services had a prominent effect on improving the QoL of the low-age, rural, and without spouse elderly; Life care services had an obvious effect on prompting the QoL of the elderly aged 80 and above, rural, and without spouse senior. Conclusion: The home-based care service can improve the QoL of the elderly in China, and it plays a prominent role in promoting the QoL of the key target seniors. Nevertheless, there is an imbalance in home-based care service supply, especially the small- scale and low-quality supply of life care services, which leads to certain areas missing the sensitive intervention period.